VSD

VENTRICULAR SEPTAL DEFECTS

Objective : To show the definition and management of VSD ( Ventricular Septal Defects)

A ventricular septal defect (VSD) is a hole in the interventricular septum (IVS). VSD, in its isolated form, is the most commonly recognized congenital heart defect and represents 30% to 40% of all congenital heart malformations at birth.

Pathophysiology

left-to-right shunting of blood across the defect and a marked increase in pulmonary blood flow occurs.
The magnitude of the shunt across a VSD depends on the size of the defect. Eisenmengers complex develops when the pulmonary vascular resistance becomes highly elevated leading to reversal of shunting ( right to left)

Clinical features

Tachypnea, poor feeding, growth failure, recurrent respiratory tract infections, exercise intolerance. Eisenmengers complex or cardiac failure may develop if a large VSD is not treated early.
Those with a small VSD are either asymptomatic or are minimally sympyomatic.

Examination

A pansystolic murmur is heard in the left lower sternal border.

Investigations

Chest Radiograph
It may be normal apart of plethoric lungs for small VSDs.
The pulmonary arteries may be enlarged with plethoric lungs & possibly cardiomegaly if the presentation is late for large VSDs.

- Electrocardiogram

There may be ECG findings

Echocardiography

It's diagnostic

Cardiac Catheterization For further evaluation.

Treatment

Surgery is indicated for large VSDs or for those VSDs which didn't close spontaeously

أ.م.د. احمد عبدالامير دفار ( اختصاصي جراحة الصدر و القلب و الاوعية الدموية )

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