Ventricular Septal Defect


Summary 1)Fundamentals of Pathology by Hussain Sattar

Ventricular Septal Defect (VSD) is a defect in the septum that divides the right and left ventricles.

Diagram of the defect in VSD (Baylor Scott & White Health)

Pathophysiology 2)Wikipedia – Ventricular Septal Defect

During ventricular contraction, or systole, some of the blood from the left ventricle leaks into the right ventricle, passes through the lungs and reenters the left ventricle via the pulmonary veins and left atrium. This has two net effects. First, the circuitous refluxing of blood causes volume overload on the left ventricle. Second, because the left ventricle normally has a much higher systolic pressure (~120 mmHg) than the right ventricle (~20 mmHg), the leakage of blood into the right ventricle therefore elevates right ventricular pressure and volume, causing pulmonary hypertension with its associated symptoms. In serious cases, the pulmonary arterial pressure can reach levels that equal the systemic pressure. This reverses the left to right shunt, so that blood then flows from the right ventricle into the left ventricle, resulting in cyanosis, as blood is by-passing the lungs for oxygenation.

Causes 3)Rapid Review Pathology by Edward Goljan 

  • Associated with Corrected Transpositions, Tetralogy of Fallot, Cri du chat syndrome and Fetal Alcohol Syndrome

Echocardiograph – Moderate VSD in mid-muscular part of the sternum (Wikipedia)

Symptoms 4)First Aid for the Basic Sciences: Organ Systems by Tao Le

  • Harsh systolic murmur
  • Poor growth
  • Fatigue with feeding
  • Respiratory infections

Diagnosis 5)First Aid for the Basic Sciences: Organ Systems by Tao Le

  • Cardiac Auscultation – harsh, nonradiating, holosystolic murmur best heard at the fourth and fifth intercostal area

Treatment 6)Fundamentals of Pathology by Hussain Sattar

  • Surgical Closure

 Comments/Associations 7)Rapid Review Pathology by Edward Goljan

  • Risk for infective endocarditis

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