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