Ventricular septal defect
VSDs account for 25% of all CHD
(2/1000 live births). They may occur in isolation or as part of complex
malformations. The clinical features depend on the size and location of the
defect.
·
Large/small
VSD.
·
Perimembranous.
·
Muscular.
·
Multiple/small
defects (maladie de Roger).
·
Asymptomatic
(typical/early).
·
Heart
failure (breathlessness—after the first few days of life).
·
Recurrent
chest infections.
·
Cyanosis
(rare after 1st decade of life)—s to
Eisenmenger syndrome.
·
Endocarditis
(late).
Pansystolic murmur—lower left
sternal edge parasternal thrill.
The majority of defects will close
spontaneously.
·
Medical: treat heart failure if present.
·
Surgery: indicated if severe heart failure;
pulmonary hypertension. This is
performed at 3mths of age, before the pulmonary hypertension causes pulmonary
vascular disease (Eisenmenger syndrome).
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