Textbook - ventricular septal defect Flashcards
Left ventricular pressure is higher than right ventricular pressure; blood therefore moves from left to right and ______ _______ _____ increases.
Left ventricular pressure is higher than right ventricular pressure; blood therefore moves from left to right and pulmonary blood flow increases.
what causes central cyanosis to develop?
eisenmenger’s complex
what are the causes of VSD?
congenital
post MI
what are the symptoms in infancy?
severe heart failure but may remain assymptomatic and be detected in later life
small VSDs are assymptomatic and usually _____ spontaneously.
small VSDs are assymptomatic and usually close spontaneously.
a moderate VSD produces ____ and _______ with cardiac enlargement and a prominent ____ _____
a moderate VSD produces fatigue and dyspnoea with cardiac enargement and a prominent apex beat
smaller holes, which are haemodynamically ___ stable , give ______ murmurs
smaller holes, which are haemodynamically more stable , give louder murmurs
what does the murmur sound like with smallish holes?
Classically a harsh pansystolic murmur is heard at the left sternal edge, with a systolic thrill ± parasternal heave.
what may be associated with the murmur? 2
parasternal heave and systolic thrill
larger holes are associated with signs of pulmonary _________
hypertension
what are the complications ? 5
- Aortic regurgitation
- infundibular stenosis
- Infective endocarditis/ subacute bacterial endocarditis
- pulmonary hypertension
- eisenmenger’s complex
what investigations should be done?
- ECG
- CXR
- cardiac catheterisation
what may a normal ECG indicate?
small VSD
what may be seen on ECG with a moderate VSD?
LAD and LVH
what may be seen on ECG with a large VSD?
RVH and LVH
what may be seen on cxr for small VSD?
normal heart size ± mild pulmonary plethora
what may be seen on cxr for large VSD?
cardiomegaly, large pulmonary arteries and marker pulmonary plethora
what would be noted on cardiac catherterisation ?
step up in O2 sats in right V
what is the treatment at first ?
this is medical at first as many close spontaneously
what are the indications for surgical closure? 4
failed medical therapy, symptomatic VSD, shunt >3:1, SBE/IE
