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Pathology
A defect in the ventricular septum, small defects are smaller than the aortic valve
and large defects larger than the aortic valve
Aetiology
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Signs
A thrill may be felt at the left lower sternal edge
Pansystolic murmur at lower left sternal edge – Maladie De Roger present
S2 is quiet/normal in small defects and loud in large defects
Symptoms
May be asymptomatic if small
Larger defects present early after 1 week of age with symptoms of heart failure or recurrent chest infections.
Investigations
ECG: Varies from normal to the presence of right ventricular hypertrophy
Chest X-Ray: Cardiomegaly and increased pulmonary vasculature
Echo: Assesses heart structure and confirms defect
Treatment
Conservative Management: Asymptomatic small VSDs close spontaneously
Medical: Treat symptoms of heart failure
Surgical: Correction required by 3-5 months of age for large defects
Prognosis
Prognosis is good once defects corrected however if untreated then development of Eisenmenger Syndrome is a life threatening complication.
If surgical correction not performed, heart failure and pulmonary hypertension
may occur in large defects
Eisenmenger syndrome may develop if large defects not treated
Infective endocarditis
Aortic Regurgitation
Key Facts
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Key Images
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Key References
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