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.
- Large/small VSD.
- 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 pulmonary hypertension causes pulmonary vascular disease (Eisenmenger syndrome).