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Y4R6 - Pediatrics II 👶 > L4: Acyanotic Heart Diseases - VSD > Flashcards

L4: Acyanotic Heart Diseases - VSD Flashcards

1
Q

Types of Acyanotic Congenital Heart Diseases

A
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2
Q

Incidence of VSD

A

Accounts for 25 - 30% of congenital heart diseases

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3
Q

Anatomy of Ventricular Septum

A
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4
Q

Types of VSD

A
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4
Q

Types of VSD

  • Most Common Type
A

Peri-membranous (or membranous)

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5
Q

Physiologic Consequences of VSD

A
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6
Q

Physiologic Consequences of VSD

  • Size of VSD
A
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7
Q

Physiologic Consequences of VSD

  • Difference between SVR & PVR
A
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8
Q

Large VSD

A
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9
Q

Clinical Course of VSD

A
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10
Q

Clinical Course of VSD

  • Small VSD
A

Patients with small VSDs rarely have symptoms related to the defect

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11
Q

Clinical Course of VSD

  • Large VSD
A
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12
Q

As pulmonary vascular disease gradually develops ……

A

symptoms of Left to Right shunt

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13
Q

Symptoms of Small VSD

A

Asymptomatic
- The murmur is usually found during a routine physical examination

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14
Q

Signs of Small VSD

A
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15
Q

Signs of Small VSD

  • Heart Sounds
  • Thrill
  • Murmur
A
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16
Q

Signs of Small VSD

  • Site of Murmur
A

Left parasternal area (LLSB)

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17
Q

Signs of Small VSD

  • Characters of Murmur
A

Loud, harsh, or blowing

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18
Q

Signs of Small VSD

  • Radiation of Murmur
A

No area of selective propagation
- May be propagated all over the precordium

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19
Q

Signs of Small VSD

  • Timing of Murmur
A

Pansystolic

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20
Q

CP of Moderate VSD

A

As small VSD plus:

  • Apical mid diastolic murmur (Relative Mitral Stenosis)
  • P2 —–> Slightly accentuated
21
Q

Symptoms of Large VSD

22
Q

Signs of Large VSD

23
Q

Signs of Large VSD

  • General
A

In cases of Eisenmenger syndrome —–> Cyanosis, clubbing

24
Q

Signs of Large VSD

  • Insperction & Palpation (Precordial Bulge)
A

(Prominence of the left precordium is common)

25
Q

Signs of Large VSD

  • Pericordial Activity
A

(Volume overload)

26
Q

Signs of Large VSD

  • Apex
27
Q

Signs of Large VSD

  • Pulsation
A

Left parasternal pulsation

28
Q

Signs of Large VSD

  • Thrill
29
Q

Signs of Large VSD

  • Heart Sounds
A

Accentuated P, with narrow splitting “pulmonary hypertension”

30
Q

Signs of Large VSD

  • Murmur
A
  • Less harsh & more blowing (as no significant pressure gradient).
  • Murmur of relative Mitral stenosis
31
Q

Why isolated large VSD is not a cause of heart failure in neonates?

A
  • As the normal postnatal delay in fall of pulmonary vascular resistance limits the magnitude of Lt —-> Rt shunt in the neonatal period
  • Delayed the occurrence of symptoms of heart failure till the 4 - 6 weeks after birth
32
Q

Investigations for VSD

33
Q

Investigations for VSD

  • Chest X-Ray
34
Q

Investigations for VSD

  • ECG
35
Q

Investigations for VSD

  • ECHO
36
Q

Investigations for VSD

  • Cardiac Catheterization
37
Q

TTT of VSD

38
Q

TTT of VSD

  • Small & Moderate
39
Q

TTT of VSD

  • Catheter
40
Q

TTT of VSD

  • Catheter (Medical)
41
Q

TTT of VSD

  • Catheter (Surgical)
42
Q

Prophylaxis against IE in Small VSD & Large secundum ASD

43
Q

Natural History of VSD

44
Q

Natural History of VSD

  • Spontaneous Closure
45
Q

Natural History of VSD

  • Pulmonary vascular obstructive disease
46
Q

Natural History of VSD

  • Development of Aortic Incompetence
47
Q

Natural History of VSD

  • Infective Endocarditis
48
Q

Natural History of VSD

  • Development of infundibular pulmonary stenosis
49
Q

Natural History of VSD

  • Premature death

Y4R6 - Pediatrics II 👶 (10 decks)

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