VSD

Question 1

Most common cause of congenital heart disease

Answer 1

Ventricular septal defects

Question 2

What are the causes of VSD?

Answer 2

Chromosomal disorders
Congenital infections
Acquired causes: post-MI

Question 3

List 4 chromosomal disorders associated with VSD

Answer 3

Down’s syndrome
Edward’s syndrome
Patau syndrome
Cri-du-chat syndrome

Question 4

How may an infant present with VSD?

Answer 4

FTT
Features of HF: hepatomegaly, tachypnoea, tachycardia, pallor
Pansystolic murmur, louder in small defects

Question 5

How are small asymptomatic VSDs managed?

Answer 5

Often close spontaneously

Question 6

How are moderate-large VSDs managed?

Answer 6

Nutritional support
Drugs for HF e.g. diuretics
Surgical closure

Question 7

List 5 complications of VSDs

Answer 7

Aortic regurgitation
Infective endocarditis
Eisenmenger’s complex
Right HF
Pulmonary HTN

Question 8

What causes aortic regurgitation from ventricular septal defects?

Answer 8

Poorly supported right coronary cusp resulting in cusp prolapse

Question 9

How can VSDs lead to Eisenmenger’s complex?

Answer 9

Due to prolonged pulmonary HTN
Results in RV hypertrophy + increased RV pressure which eventually exceeds LV pressure
Results in reversal of blood flow

Question 10

What signs develop due to Eisenmenger’s complex?

Answer 10

Cyanosis
Clubbing

Question 11

What is Eisenmenger’s complex an indication for?

Answer 11

Heart-lung transplant