SYMPTOMS &
SIGNS OF VSD
RANEESH K M
VENTRICULAR
SEPTAL
o It is a cardiac anomaly
DEFECT
o It is a usually congenital defect , can also be
acquired
o In this condition, the interventricular septum
allows bloods to shunt between right and left
ventricles
o Seen in infants & children
o Incidence : 2 infants per 1000 live birth
o In most cases, it spontaneously close in
childhood before 10 years.
PATHOPHYSIOLOGY
o VSD results in shunting oxygenated blood from the
left to right ventricles
o As a result of incomplete septation of ventricles
o The left ventricle starts contracting before the right
ventricle
o The flow of blood from the left to right ventricle
starts early in systole
o When the defect is restrictive, a high pressure
gradient is maintained between two ventricles
throughout the systole.
o Acquired VSD may be result from post surgical
residual risk, trauma or myocardial infarction.
CLASSIFICATION OF VSD
TYPE 1- PARAMEMBRANOUS
Located near the valves, do not closes by its own, surgical
treatment required
TYPE 2- CONAL SEPTAL VSD
Rarest, just below the pulmonary valve
TYPE 3- AV CANAL TYPE VSD
Associated with av canal defect, located under mitral &
tricuspid valve
TYPE 4- MUSCULAR VSD
Most common, close spontaneously, it is an opening in
muscular portion of ventricular septum.
TYPES OF VSD
SYMPTOMS
1)Palpitation & increased pulse
2)Rapid & Congested breathing
3)Dyspnea on exertion
4)Cyanosis – sites lips, tounge,
hands, feet & mucous memb.
5)Sweating – due to increased symp
tone.
6)Syncope
7)Chest pain
8)Edema
9)Clubbing – Associated with lung & heart disease
10)Poor Weight gain
11)Murmur during auscultation:
Murmur sound is generated by abnormally turbulent flow of blood
through the heart
12)Precordial bulge & Hyperactive precordium
SYMPTOMS(cont…)
>Eisenmenger's syndrome(Grade IV) in adults;
*It seen in moderate & large sized vsd
*It is a type of pulmonary hypertention
*It is a pathophysiological condition
*An uncorrected large left to right shunt causes
irreversible rise in PVR leading to reversal of or
bidirectional shunt flow with resultant hypoxemia
*VSD,ASD & PDA account for 70-80% of cases
SYMPTOMS(cont…)
It includes:
Clubbing
Central Cyanosis
Dyspnea
Dysphagia
Easily fatigued while feeding or crying
Difficulty in sucking
Syncope
Hemoptysis
Cerebrovascular accident
Renal dysfunction
Hyperuricemia & Gout
Gallstones
Hypertrophic osteoarthropathy
Hyper viscosity
Erythrocytosis
Hemostatic abnormalities
ASSOCIATED WITH
MOSTLY WITH CONGENITAL DEFECTS(50%)
1)Coarctation of aorta-Narrowing of upper descending
thoracic aorta adjacent to the site of attachment of ductus
arteriosus
2)Atrial septal defect
3)Arterioventricular septal defects
4)Patent ductus arteriosus
5)Truncus arteriosus-single trunk arising from the heart
through a common valve giving origin to aorta, pulmonary
artery and coronary arteries
6)Tetralogy of fallot- Ventricular septal defcts, Pulmonary
stenosis, Overriding aorta & Right ventricular hypertrophy
ASSOCIATED WITH(cont…)
7)Trisomy 21,13 & 18
8)Chromosome 22q11 deletion
9)Tricuspid atresia
10)Intra Cardiac obstruction :Sub pulmonary, Sub aortic
Stenosis, Mitral stenosis, Anomalous muscle bundle of right
ventricle
11) Irreversible pulmonary vascular obstructive diseases
COMPLICATIONS
>Heart failure
Left HF due to aortic valve prolapse
Right HF/Cor-pulmonale due to pulmonary stenosis
Results in Hepatomegaly, Anorexia etc.
>Pulmonary diseases
>Arrhythmias
>Infective endocarditis
>Cardiomegaly
>Right ventricular tract outflow obstruction
>Hemoptysis – due to extensive systemic to pulmonary
collateralization that has developed as a compensatory
mechanism to provide pulmonary blood flow
>Progressive aortic insufficiency
>Eisenmenger's syndrome
Thank you….
