Ventricular Septal Defect

Question 1

What is a VSD

Answer 1

Congenital hole in the septum between the ventricles

Question 2

What conditions are associated with VSDs

Answer 2

Downs or Turners

Question 3

What happens to the flow of blood

Answer 3

Typically flows left to right through the hole due to increased pressure in the LV, so they remain acyanotic. Left to right shunts lead to right sided heart overload, RHF and increased flow to pulmonary vessels

Question 4

How does pulmonary hypertension occur in VSDs

Answer 4

Extra blood flow through the pulmonary vessels due to the left to right shunt in the heart. If this continues the pressure of the right side of the heart may become greater than the left resulting in Eisenmenger syndrome

Question 5

Presentation of VSDs

Answer 5

Initially symptomless, can present in adulthood with signs of decompensated HF, murmur, systolic thrill, poor feeding, dysopnoea, tachypnoea, increased WOB, failure to thrive, can be detected on antenatal scans

Question 6

Murmur heard in VSDs

Answer 6

Pan-systolic over left lower sternal border in third and fouth intercostal space

Question 7

Treatment of VSDs

Answer 7

Watched over time if mild, can close spontaneously. Corrected using transvenous catheter via femoral vein or open heart surgery