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Chapter: Paediatrics: Cardiovascular

Paediatrics: Ventricular septal defect

VSDs account for 25% of all CHD (2/1000 live births).

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.

 

Subtypes

 

·  Large/small VSD.

 

·  Perimembranous.

 

·  Muscular.

 

·  Multiple/small defects (maladie de Roger).

 

Clinical features

 

·  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).

 

Examination 

Pansystolic murmur—lower left sternal edge parasternal thrill.

 

Prognosis 

The majority of defects will close spontaneously.

 

Management

 

·  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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Paediatrics: Cardiovascular : Paediatrics: Ventricular septal defect |


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