Ventricular Septal Defect 

Introduction 

-VSD is a hole between the LV and RV 

-Most common congenital heart defect

-There are four types, classified by location: membranous, muscular, inlet and outlet  

-Muscular are the most common type 

-Membranous VSD are the most common type requiring surgical intervention (80% of cases) 

-There is no gender predilection 

-VSD allows oxygen-rich blood from the left ventricle flow into the right ventricle, which is pumped back to the lungs, even though this blood does not need oxygen. This puts more stress on heart and lungs 

Symptoms & Signs 

Symptoms correlate with size 

-Poor weight gain, dizziness, feeling tired all the time, sweating, shortness of breath 

-Complications: cyanosis with pulmonary hypertension, Eisenmenger syndrome, endocarditis, heart failure 

Small shunts are associated with loud, harsh holosystolic murmurs in the left third and fourth interspaces along the sternum with a narrowly split second heart sound 

Diagnosis

Chest X-ray: cardiomegaly, enlarged PA, increased vascular markings 

ECG: normal or right, left, or biventricular hypertrophy 

Echocardiogram: confirms diagnosis 

Treatment 

-Degree of shunting measured during cardiac catheterization dictates management 

-Asymptomatic small shunts do not require treatment 

-Medium and large VSDs may need to be fixed with surgery or heart catheterization 

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