Congential Heart Defects - Ventricular Septal Defect

Question 1

Defintion

Answer 1

Most common congenital defect
Left to right shunt
Acyanotic
Risk of Eisenmengers syndrome + RVH later

Question 2

Small VSD symptoms

Answer 2

Size matters
- small defect leads to minimal left to right shunting across ventricles + not assosciated with any increase in pulmonary vascular resistance or symptoms

Question 3

Large VSD Signs

Answer 3

Larger defects can be heard on auscultation = PAN SYSTOLIC MURMER
- Best heard over the lower left sternal border in the 3rd + 4th intercostal space
- May also be a palpable systolic thrill
Liver enlargement
Left sided HF
Peripheral pitting oedema
Ascites

Question 4

Large VSD symptoms

Answer 4

Exercise intolerance
Poor feeding
Dyspnoea
Tachypnoea
Failure to thrive

Question 5

Risk factors

Answer 5

Foetal alcohol syndrome
Down syndrome
Turners syndrome

Question 6

Diagnosis

Answer 6

FIRST LINE = Doppler ECHO

Question 7

Treatment

Answer 7

May close spontaneously in 1 year
Surgical or percutaneous closure of VSD