What part of the conduction system might be at risk for abnormalities when a ventricular septal defect is present?

In the presence of a ventricular septal defect (VSD), the conduction system at risk for abnormalities is the bundle of His and the Purkinje fibers. The altered hemodynamics and increased blood flow can lead to stretch and potential damage to these structures, resulting in conduction delays or arrhythmias. Additionally, the proximity of the defect to the conduction pathways may predispose them to electrical disturbances.