Textbook - ventricular septal defect Flashcards

1
Q

Left ventricular pressure is higher than right ventricular pressure; blood therefore moves from left to right and ______ _______ _____ increases.

A

Left ventricular pressure is higher than right ventricular pressure; blood therefore moves from left to right and pulmonary blood flow increases.

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2
Q

what causes central cyanosis to develop?

A

eisenmenger’s complex

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3
Q

what are the causes of VSD?

A

congenital

post MI

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4
Q

what are the symptoms in infancy?

A

severe heart failure but may remain assymptomatic and be detected in later life

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5
Q

small VSDs are assymptomatic and usually _____ spontaneously.

A

small VSDs are assymptomatic and usually close spontaneously.

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6
Q

a moderate VSD produces ____ and _______ with cardiac enlargement and a prominent ____ _____

A

a moderate VSD produces fatigue and dyspnoea with cardiac enargement and a prominent apex beat

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7
Q

smaller holes, which are haemodynamically ___ stable , give ______ murmurs

A

smaller holes, which are haemodynamically more stable , give louder murmurs

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8
Q

what does the murmur sound like with smallish holes?

A

Classically a harsh pansystolic murmur is heard at the left sternal edge, with a systolic thrill ± parasternal heave.

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9
Q

what may be associated with the murmur? 2

A

parasternal heave and systolic thrill

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10
Q

larger holes are associated with signs of pulmonary _________

A

hypertension

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11
Q

what are the complications ? 5

A
  • Aortic regurgitation
  • infundibular stenosis
  • Infective endocarditis/ subacute bacterial endocarditis
  • pulmonary hypertension
  • eisenmenger’s complex
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12
Q

what investigations should be done?

A
  • ECG
  • CXR
  • cardiac catheterisation
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13
Q

what may a normal ECG indicate?

A

small VSD

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14
Q

what may be seen on ECG with a moderate VSD?

A

LAD and LVH

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15
Q

what may be seen on ECG with a large VSD?

A

RVH and LVH

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16
Q

what may be seen on cxr for small VSD?

A

normal heart size ± mild pulmonary plethora

17
Q

what may be seen on cxr for large VSD?

A

cardiomegaly, large pulmonary arteries and marker pulmonary plethora

18
Q

what would be noted on cardiac catherterisation ?

A

step up in O2 sats in right V

19
Q

what is the treatment at first ?

A

this is medical at first as many close spontaneously

20
Q

what are the indications for surgical closure? 4

A

failed medical therapy, symptomatic VSD, shunt >3:1, SBE/IE