In cases of ventricular septal defect with left to right shunting, which structure may show signs of dilation?

In the context of a ventricular septal defect (VSD) with left to right shunting, the correct structure that may show signs of dilation is the right ventricle. When a VSD is present, the left-to-right shunting allows oxygen-rich blood from the left ventricle to flow into the right ventricle. This results in an increased volume of blood returning to the right side of the heart, leading to increased pressure and volume overload. Consequently, the right ventricle must work harder to accommodate this additional blood flow, which can ultimately lead to right ventricular dilation.

While the left atrium can experience some increase in volume due to the additional blood flow, it is primarily the right ventricle that exhibits marked dilation in this scenario. In contrast, the left ventricle is not typically dilated in this condition since it is not directly affected by the volume overload from the right to left shunting. The right atrium may have some changes, but dilation is more characteristic of the right ventricle due to the hemodynamic effects of the shunt. Therefore, the correct structure to focus on in the case of dilation due to left-to-right shunting in a VSD is the right ventricle.