🫀 Mirza's Cardiology Notes

Ventricular Septal Defect (VSD)

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  • Dilates the Left side of the heart
    • to dilate a chamber, you need to fill it during diastole
    • systole: LV contracts → blood travels through VSD into RV and into the pulmonary arteries.
      • This excess blood then comes back via the pulmonary vv. into the LA and into the LV, ∴ the excess blood fills the LA and LV during diastole and VSDs lead to left heart enlargment
  • Due to flow dynamics of the VSD, the AV and/or TV can be “sucked into” the VSD → aortic regurgitation and/or tricuspid regurgitation
  • ECG
    • LAE or LVH (if hemodynamically significant VSD)
  • 4 types of VSD by location
    • membranous VSD (perimembranous)
    • inlet VSD (atrioventricular canal defect)
    • muscular VSD
    • subpulmonary VSD (subarterial)
      • found just beneath the pulmonary valve
      • most common in patients of Japanese 🇯🇵 descent

Echo in VSD

  • Membranous VSD

    • Echo in PSAX aortic view: you will see defect in the area of the RCC and the septal leaflet of the TV → high velocity jet into RVOT

  • Inlet VSD

Management

  • Sources:

Muscular VSD

Non-Muscular VSD

Unrepaired VSD in Adult

Repaired VSD in Adult

Footnotes

  1. https://www.acc.org/Latest-in-Cardiology/Articles/2023/05/30/10/47/Clinical-Practice-Algorithm-For-the-Follow-Up-of-Unrepaired-and-Repaired-Ventricular-Septal-Defects ↩

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