Ventricular Septal Defect

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Ventricular Septal Defect ( VSD )

Most common Congenital heart disease. (15-20%)

MC type - Perimembranous (70%)

Comparing size of VSD with root of Aorta, it can be divided as :

Small	Medium	Large
<1/3 of root of Aorta If < 3 mm ( de Roger’s defect )	In between Small and Large	>1/2 of root of Aorta
Loud Pansystolic Murmur at lower left sterna border		Absent or ejection systolic murmur
Asymptomatic	Symptoms : at 6-10wks Failure to thrive Recurrent infections Feeding difficulty CHF 1st chamber to enlarge is LA	Symptoms : at 6-10wks Failure to thrive Recurrent infections Feeding difficulty CHF 1st chamber to enlarge is LA
	LVH (not right)	LVH (not right)
		Delayed diastolic murmer at mitral apex. -> Large VSD

Complictions :

1. MC - Infective endocarditis(IE) (VSD is also most common disease which has IE)
2. CHF at 6-10 wks
3. Eisenmenger's Syndrome

Treatment :

1. Initially Medical (3D)

• Digitalis , diuretics , Dialators

2. Surgery if :

• Medical treatment fail
• Perimemberanous and Muscular VSD
• Supracristal VSD (rare type)
• Pulmonary/systemic blood flow >2 (MCQ)

NOTE : SURGERY CONTRAINDICATED IF EISENMENGER has developed.

Another Term to remember :
Swiss Cheese VSD = Multiple apical VSDs

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MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel