Cardiovascular Medicine Book

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Ventricular Septal DefectAka: VSD

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  1. See also
    1. Congenital Heart Disease
    2. Congenital Heart Disease Causes
  2. Epidemiology
    1. Incidence: 15-25% of Congenital Heart Disease
      1. Most common Congenital Heart Disease cause
      2. Most common CHD found in chromosomal abnormalities
    2. More common in males
  3. Pathophysiology
    1. Defect in interventricular septal wall
      1. Most often located in membranous ventricular septum
  4. Signs and symptoms
    1. Severity of symptoms related to:
      1. Defect size
      2. Pulmonary vascular resistance
      3. Associated cardiac lesions
    2. Small to moderate VSD
      1. Normal P2 component of the Second Heart Sound
      2. Pansystolic harsh murmur
        1. Grade II-VI of VI
        2. Located at lower left sternal border
    3. Large VSD with significant shunt
      1. Includes moderate VSD findings
      2. Mid-diastolic flow rumble at apex
      3. Congestive Heart Failure signs and symptoms
    4. Marked Pulmonary Hypertension
      1. Right Ventricular lift
      2. Loud P2 component of the Second Heart Sound
      3. Short systolic ejection murmur at left sternal border
  5. Radiology (large defect findings)
    1. Chest XRay
      1. Cardiomegaly
      2. Increased pulmonary vasculature
    2. Echocardiogram
      1. Defines position and size of defect
  6. Management: Medical
    1. Small Ventricular Septal Defect
      1. No surgical repair indicated
      2. SBE Prophylaxis
    2. Congestive Heart Failure
      1. Diuretics
      2. Digoxin
  7. Management: Surgical repair indications
    1. Growth failure refractory to medical therapy
    2. Pulmonary Hypertension
    3. Pulmonary to systemic flow ratio > 2:1
  8. Course
    1. Spontaneous closure age <6 months: 30-40% related to:
      1. Membranous and muscular defects
      2. Smaller defects
  9. Complications: Without repair
    1. Congestive Heart Failure
    2. Eisenmenger's Complex
  10. Complications: With repair
    1. Conduction defect: transient Right Bundle Branch Block
  11. References
    1. Saenz (1999) Am Fam Physician 59(7):1857
    2. Cyran (1998) PREP review lecture, October, Phoenix
    3. Merenstein (1994) Pediatrics, Lange

Ventricular Septal Defects (C0018818)

Definition (MSH)Developmental abnormalities in any portion of the VENTRICULAR SEPTUM resulting in abnormal communications between the two lower chambers of the heart. Classification of ventricular septal defects is based on location of the communication, such as perimembranous, inlet, outlet (infundibular), central muscular, marginal muscular, or apical muscular defect.
ConceptsCongenital Abnormality (T019) , Disease or Syndrome (T047)
ICD9745.4, 745.4
MSHD006345
EnglishDEFECT INTERVENTRICULAR SEPTUM, Interventricular septal defect, Intraventricular Septal Defect, Intraventricular Septal Defects, Septal def.-ventricular, SEPTUM INTERVENTRICULAR PATENT, VENTRICULAR SEPT DEFECT, Ventricular septal abnormality, Ventricular septal def., Ventricular septal defect, Ventricular septal defect`, Ventricular Septal Defects, VSD, VSD - Ventricular septal defect
SpanishCIV, defecto del tabique interventricular, defecto del tabique ventricular, defecto septal interventricular
Parent ConceptsHeart Septal Defects (C0018816), Cardiac and circulatory congenital anomalies (C0810060), Congenital Abnormality (C0000768), Cardiac Disorders, General, Functional and NEC (C0549515), Bulbus cordis anomalies and anomalies of cardiac septal closure (C0158606), Ventricular Septal Defects (C0018818), Duplicate concept (C1274013), Structural disorder of heart (C1290384), Disorder of cardiac ventricle (C1562298)
SourcesAOD, CCS, COSTAR, CST, DXP, ICD9CM, MSH, MTH, MTHICD9, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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