Ventricle Septal Defect

Question 1

Ventricular Septal Defect

Answer 1

A hole in the septum between the left and right ventricles. It is the most common heart defect in the UK and affects approximately 20% of children

Question 2

Symptoms of a small VSD

Answer 2

May be asymptomatic and may self resolve

Question 3

Symptoms of a large VSD

Answer 3

Poor eating, failure to thrive, heart murmur, fast breathing, fatigue, pale, poor weight gain, sweating, tachypnoea

Question 4

Eisnenmenger Syndrome in VSD

Answer 4

Pressure can increase on the right side to the point where it is higher than the left, causing the direction of blood through the VSD to change to right to left, meaning deoxygenated blood is able to escape to the rest of the body, causing a lack of oxygen delivered to the tissues and leading to cyanosis.

Question 5

Repair of a VSD

Answer 5

Cardiac catheter device closure, open heart surgery: direct closure with stitches or patch repair

Question 6

What causes the heart murmur is VSD?

Answer 6

The sound of the extra blood being shunted through the ventricular septum

Question 7

What causes fast breathing and tachypnoea in VSD?

Answer 7

As the heart and lungs have to work faster in order to pump the excess blood around the body

Question 8

What causes poor eating in VSD?

Answer 8

Due to an inability to tolerate the excretion needed to feed properly; feeding results in a need for increased cardiac output

Question 9

Pathophysiology

Answer 9

The blood flows to a low pressure gradient; high pressure on the L to low pressure on the R. Oxygenated blood moves to the R, requiring the RV to work harder to push more blood into the lungs, causing the R to enlarge. Blood to the lungs is increased, causing narrowing of the arteries. The R has to pump against more resistance to get the blood to the lungs. The heart becomes weak, leading to a back flow of blood. L to R shunt