Ventricular Septum Defects Flashcards
True or False: VSDs can be very small and go undetected?
True. Pts with small VSDs can be asymptomatic and their condition can go unnoticed. Only hemodynamically significant VSDs will be caught early in life.
Which way do VSDs shunt blood?
From left to right. This causes a volume overload to the right heart.
What is the most common type of VSD?
A membranous VSD, those located beneath the aortic valve. It is only surgically corrected if it is causing issues.
What is Eisenmenger’s complex?
A congenital cyanotic heart defect consisting of a VSD, dextroposition of the AO, pulmonary hypertension with PA enlargement and a hypertrophic RV. It causes systemic pressures on the right side and shunt reversal.
If the tissue in a membranous VSD is abnormal what might happen?
The tissue could become a site for infection.
What is the second most common type of VSD, and what are its characteristics?
Muscular VSD; it is an abnormal opening in the mid-ventricular septum down to the apex. It can be one small opening or many fenestrations.
Which murmur does Muscular VSD mimic?
AS- because it deals with high pressures during systole.
What happens if the pressure becomes too intense?
It can rupture a wall; an acute event leading to pulmonary edema. Pt will code.
What other event may lead to septal rupture?
Post infarct VSDs. It can be any wall that is necrotic or dead tissue.
What happens in fetal development to cause a Muscular VSD?
Malalignment of the truncus and conus septa which do not meet each other, and therefore do not fuse.
What VSD consists of no IVS and is very rare?
Common Ventricle VSD.
In a Common Ventricle VSD the entire septum is absent except for what?
A low ridge usually present along the posteroinferior ventricular wall.
What happens to flow in a Common Ventricle VSD?
Everything empties into a single ventricle, flow still goes out the AO & PA but sats go down due to venous and arterial mixing.
True or False: in Common Ventricle VSD the ventricles can become hypertrophic?
True.
Define Cyanotic.
Low tissue perfusion, low oxygen causes Pt to have bluish tinge.
What is a Supracristal?
An abnormal shunt from the LVOT to the RVOT. It involves the IVS below the pulmonic valve.
What is Supracristal associated with?
It is associated with AO valve prolapse and can lead to AI.
What is Gerbode?
An abnormal shunt from LV to RA high in the IVS.
What does Gerbode put the Pt as risk for?
PE and Stroke.
What murmurs are associated with VSDs?
Murmurs of MR, TR, and PS. Harsh systolic murmur is heard over the left sternal border. The murmur is relative to the size of the VSD.
Do large VSDs cause more problems than smaller ones?
Yes. Large VSDs cause more complications and Sx. The right heart enlarges and Pt may show signs of CHF.
What arrhythmias are associated with VSDs?
PVCs
PACs
RVH on EKG
Increased HR
What does a chest xray of a Pt with VSD look like?
May be normal if there is no evidence of CHF. If VSD is significant there will be an increased cardiac silhouette and pulmonary congestion.
