Ventricular Septal Defect Flashcards
What is ventricular septal defect (VSD)?
It is defined as a congenital condition in which there is formation of a hole within the septum between the two ventricles
What class of congential heart disease is ventricular septal defect?
Acyanotic
What is the most common congential cardiovascular disease?
Ventricular septal defect
What is the pathophysiological consequence of ventricular septal defect?
There is increased pressure in the left ventricle in comparison to the right, blood will flow from the left to the right – through the hole
The blood still flows around the lungs before entering the rest of the body, therefore individuals remain acyanotic
This left-to-right shunt leads to right sided overload, right heart failure and increased blood flow into the pulmonary vessels
Due to the increased blood flow through the right ventricle, over time there is increased pressure within the pulmonary vessels – leading to pulmonary hypertension
How can ventricular septal defect result in the development of Eisenmenger syndrome?
When pulmonary hypertension continues, the pressure in the right side of the heart may become greater than the left, resulting in blood being shunted from right-to-left, and therefore avoiding the lungs
Ultimately, this results in cyanosis – which is referred to as Eisenmenger Syndrome
What seven risk factors are associated with ventricular septal defect?
Down’s Syndrome
Turner’s Syndrome
Edward’s Syndrome
Patau Syndrome
Cri-Du-Chat Syndrome
Congenital Infections
Post Myocardial Infarction
What are the nine clincial features of ventricular septal defect?
Failure To Thrive
Feeding Difficulties
Pallor
Dyspnoea
Pan-Systolic Murmur
Systolic Thrill
Tachycardia
Tachypnoea
Hepatomegaly
Describe the murmur associated with ventricular septal defect
The murmur spans the entire systolic period
It is loudest at the left lower sternal border in the third and fourth intercostal spaced
What three investigations are used to diagnose ventricular septal defect?
ECG Scans
Chest X-Ray (CXR)
ECHO Scans
What is the feature of small ventricular septal defects on ECG scans?
Right ventricular hypertrophy – which manifests as tall R waves or upright T waves in leads V4 and V1
What is the feature of moderate to large ventricular septal defects on ECG scans?
Left ventricular hypertrophy features – which manifests as increased voltage in leads V5, V6, II, III and aVF
What are the three features of ventricular septal defects on CXRs?
Cardiomegaly
Pulmonary Oedema
Pulmonary Artery Enlargement
What is the gold standard investigation used to diagnose ventricular septal defects?
ECHO Scans
What is the feature of ventricular septal defects on ECHO scans?
A hole within the ventricular septum
What is the conservative management option of small ventricular septal defects (<5mm)?
It involves regular monitoring and advising individuals that it should close spontaneously
