Ventricular Septal Defect (VSD)

Ventricular Septal Defect (VSD)

Pathology:                   A defect in theventricular septum, small defects are smaller than the aortic valve

and large defects larger than the aortic valve


Symptoms:                   Maybe asymptomatic if small

Larger defects present early after 1 week of age withsymptoms of heart failure or recurrent chest infections.


Signs:                              A thrill may befelt at the left lower sternal edge

Pansystolicmurmur at lower left sternal edge – Maladie De Roger present

S2 isquiet/normal in small defects and loud in large defects


Investigations:          ECG: Variesfrom normal to the presence of right ventricular hypertrophy

Chest X-Ray: Cardiomegaly andincreased pulmonary vasculature

Echo: Assesses heart structure and confirmsdefect


Treatment:                  ConservativeManagement: Asymptomatic small VSDs close spontaneously

Medical: Treat symptoms of heart failure

 Surgical:Correction required by 3-5 months of age for large defects


Complications:          Ifsurgical correction not performed, heart failure and pulmonary hypertension

may occur in largedefects

Eisenmenger syndrome may develop if large defects nottreated

Infective endocarditis



Prognosis:                   Prognosisis good once defects corrected however if untreated then development ofEisenmenger Syndrome is a life threatening complication.




Text Box: 	Maladie De Roger
	Smaller the lesion, louder the murmur


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