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Ventricular septal defect
Ventricular septal defect
MC congenital heart defect that usually closes in childhood so LC seen in adults
Can also happen with MI
PATHO
PATHO
Can be alone or with other defects (TOF) and associated with Down syndrome, intrauterine infections (TORCH), fetal etOH
Pars membranacea (membranous septum) MC involved
Membranous region of septum grows down
Muscular ridge grows up ➔ x perforations instead of one hole
SSX
SSX
Harsh, holo(pan)systolic murmur at left lower sternal border
↑ left side afterload ➔ ↑ intensity (handgrip)
Size of defect determines severity of sx
Smaller defects are louder
DX
DX
ECHO localizes defect, and determine shunting volume
TX
TX
Usually heals spontaneously so follow til 1yo
Surgical closure (patch repair): by 2yo if it doesn't close, severe HF sx, or developing pulmonary HTN
Heart and LUNG transplant once Eisenmenger syndrome develops
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