Chapter 26: Ventricular Septal Defect (VSD) (Children)

Question 1

Ventricular Septal Defect (VSD)

Answer 1

acyanotic
-left-to-right shunting
-forms in the same way as an ASD
-a hole in the wall that separates the heart’s lower chambers (ventricles)
-in fetal development, at gestational age of 4 to 8 weeks, the wall is formed when a superior and inferior limb (like a divider) of tissue come together to create a wall between the two chambers
>a defect in the formation of this wall can be a single opening, or the wall may be fraught with multiple defects, sometimes referred to as a Swiss cheese VSD
-defect may be located anywhere on the ventricular septal wall

Question 2

Signs and Symptoms

Answer 2

mostly asymptomatic
>large VSD with significant left-to-right shunt: signs of right ventricular failure
-SOB
-feeding difficulties
-poor growth
-easy fatigability
-recurrent pulmonary infections
>murmur:
-a harsh murmur along with a thrill at the lower left sternal border
-pansystolic (persisting throughout systole)

Question 3

Diagnosis

Answer 3

based on audible heart murmur along with other s/s

• chest radiograph and ECG support the diagnosis
• echocardiogram, cardiac Cath, and/or cardiac magnetic resonance imaging (MRI) confirm the diagnosis

Question 4

Nursing Care

Answer 4

postoperative management of the child

Question 5

Medical Care

Answer 5

usually repaired surgically

Question 6

Complications

Answer 6

child can suffer from right ventricular overload from left-to-right (acyanotic) shunting of blood caused by the high pressure gradient from the left to the right side