Atrial and Ventricular septal defects

Question 1

what re the 3 main types of VSD

- what is the shunt?

Answer 1

• subaortic
• perimembranous
• muscular

left to right

Question 2

Clinical presentation of VSD?

Answer 2

Pansystolic murmur lower left sternal edge, sometimes with thrill

Question 3

Difference in murmurs in small and large VSD’s

Answer 3

small VSDs, early systolic murmur

VSDs diastolic rumble due to relative mitral stenosis

Question 4

what do you get in large VSD’s - what does it lead to/

Answer 4

Signs of cardiac failure in large VSDs, eventually leading to biventricular hypertrophy and pulmonary hypertension

Question 5

Syndrome associated with VSD?

Answer 5

Eisenmenger

Question 6

How to close VSD?

Answer 6

Amplatzer or other occlusion device, trans-catheter

Patch closure, open heart surgery

Question 7

ASD clinical signs?

Answer 7

Few clinical signs in early childhood, good chance of spontaneous closure

• adult hood = atrial fibrillation, heart failure or pulmonary hypertension

Question 8

murmur and sounds heard with ASD?

Answer 8

splitting of 2nd heart sound, pulmonary flow murmur