Children with large VSDs (ventricular septal defects) will have high pressure in the right side of the heart until surgery is performed. The general rule is that repair in the first year of life usually (but not always) results in a return of the right heart pressure to normal. Children with large VSDs usually develop congestive heart failure symptoms in the first few months of life. If your child was not diagnosed to have a large VSD until 7 months of age, that could mean that there is something different about the resistance in his lungs. That could mean a predisposition to ongoing higher than normal blood pressure in the lungs. The echocardiogram is not definitive for pulmonary hypertension, especially if there is a residual VSD around the patch, but it certainly can suggest that there is a problem. That is why a heart catheterization is sometimes necessary to determine the true pressure and resistance in the lungs, and see if there are other residual factors present that could explain it. If the lung artery pressure is high, then it is a question of "how high", Significant pulmonary hypertension (more than 1/2-2/3 of the systemic blood pressure) is a serious risk for future heart failure and lung failure. An evaluation by a pulmonary hypertension specialist might be needed to see if your child merits treatment with one or more of the availablable oral medications that can help to "relax" the blood vessels in the lungs and thus could improve the pulmonary hypertension (but not cure it).
Just on this we took my son to ED because he was looking a bit pale and they gave him a chest X-Ray and said his lungs don't look "wet". Is this a good sign?