Materiały źródłowe

• #1 Ventricular Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470330/

  Ventricular septal defects (VSDs) are the most prevalent congenital cardiac anomaly in children and the second most common heart defect in adults, after bicuspid aortic valves. […] Color Doppler transthoracic echocardiography (TTE) is the primary diagnostic tool, although transesophageal echocardiography is used when TTE is inconclusive. […] This activity focuses on understanding the presentation and pathophysiology of VSDs, providing clinicians with up-to-date knowledge, practical insights, and strategies to enhance diagnostic and management skills and optimize patient care and outcomes. […] The primary pathophysiological mechanism involves abnormal communication between the right and left ventricles and, in rare cases, between the left ventricle and right atrium, leading to shunt formation and subsequent hemodynamic compromise.

• #2 Ventricular Septal Defects

  https://www.utmb.edu/pedi_ed/CoreV2/Cardiology/cardiologyV2/cardiologyV26.html

  Isolated ventricular septal defects (VSDs) constitute 25-30% of all congenital heart diseases (CHD) in children. VSD may be present in 50% of CHDs such as in tetralogy of Fallot, double outlet right ventricle, truncus arteriosus and others. […] A holosystolic murmur is heard at the left sternal border due to turbulence across the VSD. The intensity of the murmur is inversely proportional to the magnitude of the shunt; the smaller the shunt, the louder the murmur and vice versa. […] An early diastolic murmur due to pulmonary insufficiency may be heard if pulmonary hypertension develops. […] While more than half of small and medium sized VSDs close spontaneously, only about 10% of large VSDs close spontaneously. […] Asymptomatic children with a small or medium sized VSD need only supportive care, with the expectation that the VSD will close in the first few years of life. If CHF develops, treatment consists of diuretics, afterload reducing agents such as ACE inhibitors, and possibly digoxin.

• #3 Ventricular Septal Defect – Management – TeachMePaediatrics

  https://teachmepaediatrics.com/cardiology/congenital-heart-defects/ventricular-septal-defect/

  Ventricular Septal Defect (VSD) is the most common congenital heart defect (CHD) (1). VSD is defined as a condition where there is a hole in the septum separating the left and right ventricles. It can occur as an isolated lesion or alongside other CHDs. […] VSD occurs in approximately 50% of all children with a CHD and in 20% as an isolated lesion (3). The prevalence of an isolated VSD is, on average, 4.2 per 1000 births (4). Studies show that the prevalence of VSD has increased significantly in recent decades, shown to be primarily due to improved diagnosis. […] The size of the defect is the main determinant of the haemodynamic consequences of the VSD: […] Moderate sized VSD: The flow of blood through the VSD is great enough to cause a significant increase in blood flow through the pulmonary circulation.

• #4 Ventricular septal defect (VSD) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ventricular-septal-defect/diagnosis-treatment/drc-20353501

  Some ventricular septal defects (VSDs) are diagnosed soon after a child is born. However, ventricular septal defects (VSDs) may not be diagnosed until later in life. Sometimes a ventricular septal defect (VSD) can be detected by a pregnancy ultrasound before the baby is born. […] If ventricular septal defect is present, the health care provider may hear a whooshing sound (heart murmur) when listening to the heart with a stethoscope. […] Tests that are done to help diagnose ventricular septal defect include: […] Echocardiogram. This is the most commonly used test to diagnose a ventricular septal defect. Sound waves are used to create pictures of the heart in motion. An echocardiogram can show how well blood is moving through the heart and heart valves. […] Electrocardiogram (ECG). This quick and painless test records the electrical activity of the heart. It can show how fast or how slowly the heart is beating.

• #5 Ventricular Septal Defect (VSD) | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/v/vsd

  A ventricular septal defect (VSD) is a hole between the right and left pumping chambers of the heart. […] Most ventricular septal defects can be diagnosed on physical exam, due to their murmur. […] This heart defect may also be diagnosed on fetal echocardiograms. It is one of the cardiac defects that may be found on screening ultrasounds. Early diagnosis of the defect allows for planning after birth. […] Echocardiograms can give detailed information of the anatomy of the various cardiac structures affected in this congenital defect. They also give important information about the function of the heart. […] An electrocardiogram can help determine the sizes of the chambers to see if there is strain on the heart due to the ventricular septal defect. […] A chest X-ray can help follow the progression of congestive heart failure by looking at the size of the heart and the amount of blood flow to the lungs.

• #6 Ventricular Septal Defect (VSD) Diagnosis & Treatments | Mount Sinai – New York

  https://www.mountsinai.org/locations/childrens-heart/conditions/ventricular-septal-defect

  When you learn before birth or soon after birth that your child has a ventricular septal defect, also referred to as a VSD, your concern may overwhelm you. […] If your baby has a VSD, the condition may be diagnosed in utero during a regularly scheduled echocardiogram or ultrasound during your pregnancy. However, it is possible for a VSD to be missed during pregnancy as it can be a tricky diagnosis to make in a fetus. Your child’s VSD may be diagnosed at birth when a heart murmur is heard. This can also happen later in childhood. […] If your child’s doctor suspects a heart condition, we may perform the following tests to diagnose a VSD: Physical exam—observes the pulse, blood pressure, temperature, and number of breaths your baby takes in a minute, and listens for any changes in how the heart sounds with a stethoscope. Oxygen saturation monitor—determines how much oxygen is getting into your child’s blood. Chest X-ray—shows the size and position of the heart. Electrocardiogram (ECG or EKG)—checks the electrical activity which shows how the heart’s chambers and how your child’s heart is beating. Echocardiogram—a safe, noninvasive procedure that uses high frequency ultrasound to show the structure of your child’s heart, how blood flows through the heart, and overall how your child’s heart and circulatory system are working. […] A heart with a ventricular septal defect may have other associated abnormalities, which our doctors will diagnose, explain to you, and treat as needed.

• #7 Ventricular septal defect (VSD) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ventricular-septal-defect/diagnosis-treatment/drc-20353501

  Some ventricular septal defects (VSDs) are diagnosed soon after a child is born. However, ventricular septal defects (VSDs) may not be diagnosed until later in life. Sometimes a ventricular septal defect (VSD) can be detected by a pregnancy ultrasound before the baby is born. […] If ventricular septal defect is present, the health care provider may hear a whooshing sound (heart murmur) when listening to the heart with a stethoscope. […] Tests that are done to help diagnose ventricular septal defect include: […] Echocardiogram. This is the most commonly used test to diagnose a ventricular septal defect. Sound waves are used to create pictures of the heart in motion. An echocardiogram can show how well blood is moving through the heart and heart valves. […] Electrocardiogram (ECG). This quick and painless test records the electrical activity of the heart. It can show how fast or how slowly the heart is beating.

• #8 About Ventricular Septal Defect | Congenital Heart Defects (CHDs) | CDC

  https://www.cdc.gov/heart-defects/about/ventricular-septal-defect.html

  A VSD is usually diagnosed after a baby is born. […] During a physical exam, a healthcare provider might hear a distinct whooshing sound, called a heart murmur. The size of the VSD will influence whether a healthcare provider hears a heart murmur during a physical exam. […] If signs or symptoms are present, the healthcare provider might request one or more tests to confirm the diagnosis. The most common test is an echocardiogram, which is an ultrasound of the heart. An echocardiogram can show how large the hole is and how much blood is flowing through the hole.

• #9 Ventricular Septal Defect (VSD) Types, Symptoms, Treatment

  https://www.medicinenet.com/ventricular_septal_defect/article.htm

  How do doctors diagnose a ventricular septal defect? The diagnosis of a VSD is usually suspected clinically by hearing a characteristic heart murmur. A murmur is a sound generated by abnormally turbulent flow of blood through the heart. This murmur is the result of blood being shunted through the VSD from the higher-pressure left ventricle into the lower-pressure right ventricle. At birth, this pressure imbalance is minimal and does not usually develop until later in the first week of life. As such, it is rare for a doctor to hear the murmur of a VSD until the baby is a few days of age. […] The evaluation of a child with a possible VSD is designed to confirm the diagnosis but also to check for other anatomical defects in the heart and to estimate the size of the shunt of blood from the left to right ventricle. Such an evaluation usually begins with an electrocardiogram (EKG, sometimes also abbreviated ECG) and possibly a chest X-ray. A soundwave test of the heart (echocardiogram) is used to define the anatomy and evaluate the characteristics (amount and pressures) of the shunted blood. With the advent of superb echocardiography, the previously required cardiac catheterization is rarely necessary.

• #10 Ventricular Septal Defect (VSD) Types, Symptoms, Treatment

  https://www.medicinenet.com/ventricular_septal_defect/article.htm

  How do doctors diagnose a ventricular septal defect? The diagnosis of a VSD is usually suspected clinically by hearing a characteristic heart murmur. A murmur is a sound generated by abnormally turbulent flow of blood through the heart. This murmur is the result of blood being shunted through the VSD from the higher-pressure left ventricle into the lower-pressure right ventricle. At birth, this pressure imbalance is minimal and does not usually develop until later in the first week of life. As such, it is rare for a doctor to hear the murmur of a VSD until the baby is a few days of age. […] The evaluation of a child with a possible VSD is designed to confirm the diagnosis but also to check for other anatomical defects in the heart and to estimate the size of the shunt of blood from the left to right ventricle. Such an evaluation usually begins with an electrocardiogram (EKG, sometimes also abbreviated ECG) and possibly a chest X-ray. A soundwave test of the heart (echocardiogram) is used to define the anatomy and evaluate the characteristics (amount and pressures) of the shunted blood. With the advent of superb echocardiography, the previously required cardiac catheterization is rarely necessary.

• #11 Ventricular Septal Defects

  https://www.utmb.edu/pedi_ed/CoreV2/Cardiology/cardiologyV2/cardiologyV26.html

  Isolated ventricular septal defects (VSDs) constitute 25-30% of all congenital heart diseases (CHD) in children. VSD may be present in 50% of CHDs such as in tetralogy of Fallot, double outlet right ventricle, truncus arteriosus and others. […] A holosystolic murmur is heard at the left sternal border due to turbulence across the VSD. The intensity of the murmur is inversely proportional to the magnitude of the shunt; the smaller the shunt, the louder the murmur and vice versa. […] An early diastolic murmur due to pulmonary insufficiency may be heard if pulmonary hypertension develops. […] While more than half of small and medium sized VSDs close spontaneously, only about 10% of large VSDs close spontaneously. […] Asymptomatic children with a small or medium sized VSD need only supportive care, with the expectation that the VSD will close in the first few years of life. If CHF develops, treatment consists of diuretics, afterload reducing agents such as ACE inhibitors, and possibly digoxin.

• #12 Ventricular Septal Defect (VSD): Types & Causes

  https://my.clevelandclinic.org/health/diseases/17615-ventricular-septal-defects-vsd

  A ventricular septal defect (VSD) is a hole in the wall that separates the lower chambers of your heart. […] A VSD diagnosis happens most often during childhood. Rarely, you can get a diagnosis as an adult. This is much less likely because the defect closes on its own during childhood in most cases. […] A healthcare provider can diagnose a VSD based on your child’s symptoms, a physical exam and imaging tests. Testing may not find a minor ventricular septal defect when the hole is too small to cause signs or symptoms. […] A physical exam is one of the most common ways a provider discovers a VSD. That’s because a VSD that’s large enough causes a sound called a heart murmur. A provider can hear this when listening to your child’s heart with a stethoscope. […] Tests can show changes in heart structure, heart rhythm and blood flow from a VSD. Tests that help diagnose VSD include: Echocardiogram, Electrocardiogram (EKG), Chest X-ray, Cardiac computed tomography (CT) scan, Cardiac MRI, Cardiac catheterization.

• #13 Ventricular Septal Defect (VSD): Types & Causes

  https://my.clevelandclinic.org/health/diseases/17615-ventricular-septal-defects-vsd

  A ventricular septal defect (VSD) is a hole in the wall that separates the lower chambers of your heart. […] A VSD diagnosis happens most often during childhood. Rarely, you can get a diagnosis as an adult. This is much less likely because the defect closes on its own during childhood in most cases. […] A healthcare provider can diagnose a VSD based on your child’s symptoms, a physical exam and imaging tests. Testing may not find a minor ventricular septal defect when the hole is too small to cause signs or symptoms. […] A physical exam is one of the most common ways a provider discovers a VSD. That’s because a VSD that’s large enough causes a sound called a heart murmur. A provider can hear this when listening to your child’s heart with a stethoscope. […] Tests can show changes in heart structure, heart rhythm and blood flow from a VSD. Tests that help diagnose VSD include: Echocardiogram, Electrocardiogram (EKG), Chest X-ray, Cardiac computed tomography (CT) scan, Cardiac MRI, Cardiac catheterization.

• #14 Ventricular Septal Defect (VSD) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/vsd.html

  VSDs are the most common congenital heart defect. Most VSDs are diagnosed and treated successfully with few or no complications. […] Doctors usually find a VSD in a baby’s first few weeks of life during a routine checkup. They’ll hear the heart murmur, which has certain features that let them know it’s not caused by something else. […] If your child has a heart murmur, the doctor may refer you to a pediatric cardiologist (a doctor who diagnoses and treats childhood heart conditions). […] The cardiologist will do an exam and take your child’s medical history. If the doctor thinks there’s a VSD, they may order tests such as: a chest X-ray: a picture of the heart and surrounding organs, an electrocardiogram (EKG): a record of the heart’s electrical activity, an echocardiogram: an ultrasound of the heart. Often, this is the main way doctors diagnose a VSD.

• #15 Ventricular septal defect (VSD) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ventricular-septal-defect/diagnosis-treatment/drc-20353501

  Some ventricular septal defects (VSDs) are diagnosed soon after a child is born. However, ventricular septal defects (VSDs) may not be diagnosed until later in life. Sometimes a ventricular septal defect (VSD) can be detected by a pregnancy ultrasound before the baby is born. […] If ventricular septal defect is present, the health care provider may hear a whooshing sound (heart murmur) when listening to the heart with a stethoscope. […] Tests that are done to help diagnose ventricular septal defect include: […] Echocardiogram. This is the most commonly used test to diagnose a ventricular septal defect. Sound waves are used to create pictures of the heart in motion. An echocardiogram can show how well blood is moving through the heart and heart valves. […] Electrocardiogram (ECG). This quick and painless test records the electrical activity of the heart. It can show how fast or how slowly the heart is beating.

• #16 Ventricular Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470330/

  Color Doppler transthoracic echocardiography (TTE) is the most valuable diagnostic tool for VSDs due to its high sensitivity, detecting up to 95% of cases, particularly for nonapical lesions larger than 5 mm. […] When conventional TTE results are inconclusive, transesophageal echocardiography is recommended for further evaluation. […] Electrocardiography (ECG) results are normal in about half of patients with VSD. […] Chest radiography usually appears normal in individuals with minor defects. […] Cardiac magnetic resonance imaging (MRI) and computed tomography (CT) are beneficial for evaluating complex anatomy, such as VSDs associated with other congenital heart anomalies or defects located in unusual areas that are difficult to visualize with conventional TTE. […] Cardiac catheterization is a vital diagnostic tool that provides accurate hemodynamic information, particularly regarding pulmonary vascular resistance and the response to vasodilators.

• #17 Ventricular Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470330/

  Color Doppler transthoracic echocardiography (TTE) is the most valuable diagnostic tool for VSDs due to its high sensitivity, detecting up to 95% of cases, particularly for nonapical lesions larger than 5 mm. […] When conventional TTE results are inconclusive, transesophageal echocardiography is recommended for further evaluation. […] Electrocardiography (ECG) results are normal in about half of patients with VSD. […] Chest radiography usually appears normal in individuals with minor defects. […] Cardiac magnetic resonance imaging (MRI) and computed tomography (CT) are beneficial for evaluating complex anatomy, such as VSDs associated with other congenital heart anomalies or defects located in unusual areas that are difficult to visualize with conventional TTE. […] Cardiac catheterization is a vital diagnostic tool that provides accurate hemodynamic information, particularly regarding pulmonary vascular resistance and the response to vasodilators.

• #18 Ventricular Septal Defect (VSD) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/ventricular-septal-defect-vsd

  A ventricular septal defect (VSD) is an opening in the interventricular septum, causing a shunt between ventricles. […] Diagnosis is by echocardiography. […] Diagnosis of ventricular septal defect is suggested by clinical examination, supported by chest x-ray and ECG, and established by echocardiography. […] If the VSD is large, chest x-ray shows cardiomegaly and increased pulmonary vascular markings. ECG shows right ventricular hypertrophy or combined ventricular hypertrophy and, occasionally, left atrial enlargement. […] Two-dimensional echocardiography with color flow and Doppler studies establishes the diagnosis and can provide important anatomic and hemodynamic information, including the defects location and size and right ventricular pressure.

• #19

  https://journals.lww.com/jiae/fulltext/2020/04030/ventricular_septal_defect__echocardiography.7.aspx

  In a patient with a small VSD, clinical feature of loud pansystolic murmur is the only reason for echocardiographic evaluation. […] Determination of the size of VSD is made on hemodynamic basis like degree of left-to-right shunt, presence of volume overload, and pulmonary artery pressure. […] Integration of spectral and color Doppler with 2D echocardiography greatly assists with identification and characterization of VSDs. […] Surgical closure of VSD remains the treatment of choice for large defects with good long-term results and quality of life. […] An echocardiographer must provide a clear understanding of VSD to a surgeon for planning of surgery including size, location, number of defects, and relationship with surrounding cardiac structures. […] More recently, transcatheter device closure and hybrid approach has developed as an alternate to surgical closure in carefully selected cases.

• #20 Ventricular Septal Defects: A Review | IntechOpen

  https://www.intechopen.com/chapters/81658

  Ventricular septal defects (VSDs) account for up to 30% of all congenital cardiac anomalies and are one of the most common lesions encountered in day-to-day practice. […] Echocardiography remains the main modality of definitive diagnosis for isolated defects. […] In current times, transthoracic echocardiogram (TTE) is the main modality for definitive diagnosis of VSDs. It allows to delineate size and location of the defect as well as other details such as outflow tracts, associated lesions, evidence of chamber dilation and pressures. […] Advanced imaging such as cardiac magnetic resonance (CMR) imaging is not necessary in the routine evaluation of isolated VSDs. However, it is a helpful adjunct in the diagnosis of complex anatomical variants and in the evaluation of associated defects or complications such as double chambered right ventricle and pulmonary arterial hypertension (PAH). […] Although a mainstay in diagnosis of all congenital heart defects in the past, cardiac catheterization is now reserved for cases requiring measurements of PVR.

• #21

  https://journals.lww.com/jiae/fulltext/2020/04030/ventricular_septal_defect__echocardiography.7.aspx

  Ventricular septal defects (VSDs) are among the most common congenital heart defects. […] Echocardiography plays an important role in evaluation of anatomy, hemodynamic significance, and planning of management of VSDs. […] Echocardiographic evaluation of VSD remains the mainstay in diagnosis and decision making for management in these patients. […] Distinction between different types of VSD is essential for a correct diagnosis as well as medical and surgical management. […] Echocardiography has evolved immensely over the past few decades and has revolutionised the practice of pediatric cardiology. […] A systematic echocardiographic assessment of VSD includes a detailed anatomic and hemodynamic description. […] A patient is referred for echocardiographic evaluation on the basis of clinical suspicion.

• #22 Ventricular Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470330/

  Color Doppler transthoracic echocardiography (TTE) is the most valuable diagnostic tool for VSDs due to its high sensitivity, detecting up to 95% of cases, particularly for nonapical lesions larger than 5 mm. […] When conventional TTE results are inconclusive, transesophageal echocardiography is recommended for further evaluation. […] Electrocardiography (ECG) results are normal in about half of patients with VSD. […] Chest radiography usually appears normal in individuals with minor defects. […] Cardiac magnetic resonance imaging (MRI) and computed tomography (CT) are beneficial for evaluating complex anatomy, such as VSDs associated with other congenital heart anomalies or defects located in unusual areas that are difficult to visualize with conventional TTE. […] Cardiac catheterization is a vital diagnostic tool that provides accurate hemodynamic information, particularly regarding pulmonary vascular resistance and the response to vasodilators.

• #23 Ventricular Septal Defect (VSD) | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/v/vsd

  A ventricular septal defect (VSD) is a hole between the right and left pumping chambers of the heart. […] Most ventricular septal defects can be diagnosed on physical exam, due to their murmur. […] This heart defect may also be diagnosed on fetal echocardiograms. It is one of the cardiac defects that may be found on screening ultrasounds. Early diagnosis of the defect allows for planning after birth. […] Echocardiograms can give detailed information of the anatomy of the various cardiac structures affected in this congenital defect. They also give important information about the function of the heart. […] An electrocardiogram can help determine the sizes of the chambers to see if there is strain on the heart due to the ventricular septal defect. […] A chest X-ray can help follow the progression of congestive heart failure by looking at the size of the heart and the amount of blood flow to the lungs.

• #24 Ventricular Septal Defect | Cardinal Glennon

  https://www.ssmhealth.com/cardinal-glennon/fetal-care-institute/fetal-heart-program/heart-conditions/ventricular-septal-defect

  Ventricular Septal Defect (VSD) is one of the most common congenital heart defects. […] Unlike other more severe forms of congenital heart defects, ventricular septal defects cannot always be diagnosed before birth, particularly if the hole is small. […] If your doctor suspects a fetal heart anomaly after reviewing your routine ultrasound, he or she may request a fetal echocardiogram (echo), an ultrasound of your babys heart. This safe, noninvasive test shows the structure of your babys heart and how it is functioning, which can help us determine if there is a VSD and discuss possible options for treatment after delivery. […] Most small VSDs will close on their own over months to years. For larger VSDs, open heart surgery is performed when medications are not adequate to control symptoms. This may be in the first six months of life. After surgery, babies with VSD will need regular follow-up visits with a cardiologist, but usually lead healthy, normal lives.

• #25 Ventricular Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470330/

  Color Doppler transthoracic echocardiography (TTE) is the most valuable diagnostic tool for VSDs due to its high sensitivity, detecting up to 95% of cases, particularly for nonapical lesions larger than 5 mm. […] When conventional TTE results are inconclusive, transesophageal echocardiography is recommended for further evaluation. […] Electrocardiography (ECG) results are normal in about half of patients with VSD. […] Chest radiography usually appears normal in individuals with minor defects. […] Cardiac magnetic resonance imaging (MRI) and computed tomography (CT) are beneficial for evaluating complex anatomy, such as VSDs associated with other congenital heart anomalies or defects located in unusual areas that are difficult to visualize with conventional TTE. […] Cardiac catheterization is a vital diagnostic tool that provides accurate hemodynamic information, particularly regarding pulmonary vascular resistance and the response to vasodilators.

• #26 Ventricular Septal Defects: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/ventricular-septal-defect-pro

  Ventricular septal defect (VSD) is the persistence of one or more holes in the septum that separates the left and right ventricles of the heart. […] The clinical presentation varies with the severity of the lesion: […] With a small VSD, the infant or child is asymptomatic with normal feeding and weight gain and the lesion may be detected when a murmur is heard at a routine examination. […] With a moderate-to-large VSD, although the babies are well at birth, symptoms generally appear by 5-6 weeks of age. […] The main symptom is exercise intolerance and since the only exercise babies do is feeding, the first impact is on feeding. […] Poor weight gain is a good indicator of heart failure in a baby. […] With very large VSDs the features are similar but more severe. […] The ECG is usually normal in patients with small VSDs.

• #27 Ventricular Septal Defects: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/ventricular-septal-defect-pro

  With a moderate VSD, left ventricular hypertrophy (LVH) and occasionally left atrial hypertrophy (LAH) may be seen. […] With large VSDs the ECG shows biventricular hypertrophy (BVH) with or without LAH. […] Transthoracic two-dimensional and Doppler echocardiography can identify the number, size and exact location of the defect. […] Management in the infant and child depends on symptoms, with small asymptomatic defects needing no medical management, and unlikely to need any intervention. […] Surgical repair is required if there is uncontrolled heart failure, including poor growth. […] Most defects are closed nowadays by directly placing a patch from the right ventricular side, usually with the surgeon working through the tricuspid valve. […] The prognosis for a patient with an isolated VSD is excellent. […] Spontaneous closure is common in children under 1 year old but less likely after the age of 2 years. […] In those needing surgery the surgical outcome is excellent and most units report a surgical mortality approaching zero.

• #28 Ventricular septal defect (VSD) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ventricular-septal-defect/diagnosis-treatment/drc-20353501

  Chest X-ray. A chest X-ray shows the condition of the heart and lungs. It can tell if the heart is enlarged and if the lungs have extra fluid. […] Pulse oximetry. A sensor placed on the fingertip records the amount of oxygen in the blood. Too little oxygen may be a sign of a heart or lung problem. […] Cardiac catheterization. In this test, a thin, flexible tube (catheter) is inserted into a blood vessel at the groin or arm and guided through the blood vessels into the heart. Through cardiac catheterization, doctors can diagnose congenital heart defects and determine the function of the heart valves and chambers. […] Cardiac magnetic resonance imaging (MRI) scan. Magnetic fields and radio waves are used to create detailed images of the heart. A health care provider might request this test if more information is needed after an echocardiogram. […] Computerized tomography (CT) scan. A series of X-rays create detailed images of the heart. It may be done if an echocardiogram didn’t provide as much information as needed.

• #29 Ventricular Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470330/

  Color Doppler transthoracic echocardiography (TTE) is the most valuable diagnostic tool for VSDs due to its high sensitivity, detecting up to 95% of cases, particularly for nonapical lesions larger than 5 mm. […] When conventional TTE results are inconclusive, transesophageal echocardiography is recommended for further evaluation. […] Electrocardiography (ECG) results are normal in about half of patients with VSD. […] Chest radiography usually appears normal in individuals with minor defects. […] Cardiac magnetic resonance imaging (MRI) and computed tomography (CT) are beneficial for evaluating complex anatomy, such as VSDs associated with other congenital heart anomalies or defects located in unusual areas that are difficult to visualize with conventional TTE. […] Cardiac catheterization is a vital diagnostic tool that provides accurate hemodynamic information, particularly regarding pulmonary vascular resistance and the response to vasodilators.

• #30 Ventricular Septal Defect (VSD) – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/congenital-cardiovascular-anomalies/ventricular-septal-defect-vsd

  A ventricular septal defect (VSD) is an opening in the interventricular septum, causing a shunt between ventricles. […] Diagnosis is by echocardiography. […] Diagnosis of ventricular septal defect is suggested by clinical examination, supported by chest x-ray and ECG, and established by echocardiography. […] If the VSD is large, chest x-ray shows cardiomegaly and increased pulmonary vascular markings. ECG shows right ventricular hypertrophy or combined ventricular hypertrophy and, occasionally, left atrial enlargement. […] Two-dimensional echocardiography with color flow and Doppler studies establishes the diagnosis and can provide important anatomic and hemodynamic information, including the defects location and size and right ventricular pressure.

• #31 Ventricular septal defect (VSD) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ventricular-septal-defect/diagnosis-treatment/drc-20353501

  Chest X-ray. A chest X-ray shows the condition of the heart and lungs. It can tell if the heart is enlarged and if the lungs have extra fluid. […] Pulse oximetry. A sensor placed on the fingertip records the amount of oxygen in the blood. Too little oxygen may be a sign of a heart or lung problem. […] Cardiac catheterization. In this test, a thin, flexible tube (catheter) is inserted into a blood vessel at the groin or arm and guided through the blood vessels into the heart. Through cardiac catheterization, doctors can diagnose congenital heart defects and determine the function of the heart valves and chambers. […] Cardiac magnetic resonance imaging (MRI) scan. Magnetic fields and radio waves are used to create detailed images of the heart. A health care provider might request this test if more information is needed after an echocardiogram. […] Computerized tomography (CT) scan. A series of X-rays create detailed images of the heart. It may be done if an echocardiogram didn’t provide as much information as needed.

• #32 Ventricular Septal Defect (VSD) Types, Symptoms, Treatment

  https://www.medicinenet.com/ventricular_septal_defect/article.htm

  The infant will commonly have reduced blood oxygen levels due to shunting of the LV blood into the RV. Most hospitals test for upper and lower blood oxygen levels (pulse oximetry) prior to discharging an infant from the hospital. Further studies and a consultation with a pediatric cardiologist should be undertaken prior to the infant being sent home.

• #33 Ventricular Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470330/

  Color Doppler transthoracic echocardiography (TTE) is the most valuable diagnostic tool for VSDs due to its high sensitivity, detecting up to 95% of cases, particularly for nonapical lesions larger than 5 mm. […] When conventional TTE results are inconclusive, transesophageal echocardiography is recommended for further evaluation. […] Electrocardiography (ECG) results are normal in about half of patients with VSD. […] Chest radiography usually appears normal in individuals with minor defects. […] Cardiac magnetic resonance imaging (MRI) and computed tomography (CT) are beneficial for evaluating complex anatomy, such as VSDs associated with other congenital heart anomalies or defects located in unusual areas that are difficult to visualize with conventional TTE. […] Cardiac catheterization is a vital diagnostic tool that provides accurate hemodynamic information, particularly regarding pulmonary vascular resistance and the response to vasodilators.

• #34 Ventricular septal defect (VSD) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ventricular-septal-defect/diagnosis-treatment/drc-20353501

  Chest X-ray. A chest X-ray shows the condition of the heart and lungs. It can tell if the heart is enlarged and if the lungs have extra fluid. […] Pulse oximetry. A sensor placed on the fingertip records the amount of oxygen in the blood. Too little oxygen may be a sign of a heart or lung problem. […] Cardiac catheterization. In this test, a thin, flexible tube (catheter) is inserted into a blood vessel at the groin or arm and guided through the blood vessels into the heart. Through cardiac catheterization, doctors can diagnose congenital heart defects and determine the function of the heart valves and chambers. […] Cardiac magnetic resonance imaging (MRI) scan. Magnetic fields and radio waves are used to create detailed images of the heart. A health care provider might request this test if more information is needed after an echocardiogram. […] Computerized tomography (CT) scan. A series of X-rays create detailed images of the heart. It may be done if an echocardiogram didn’t provide as much information as needed.

• #35 Diagnosis and Management of Post-myocardial Infarction Ventricular Septal Defects | ICR Journal

  https://www.icrjournal.com/articles/diagnosis-and-management-post-myocardial-infarction-ventricular-septal-defects?language_content_entity=en

  Ventricular septal defects (VSDs) are well described and are a potentially fatal complication of myocardial infarction (MI). The clinical presentation of post-MI VSD usually includes chest pain, shortness of breath and findings of low cardiac output. In up to 98 % of patients there is a new pansystolic murmur, which in almost 50 % is associated with a palpable thrill. Once a VSD is clinically suspected, the mainstay of investigation is echocardiographic imaging. Patients are often very unwell and other imaging modalities such as cardiac magnetic resonance imaging and computed tomography are less appropriate as a first-line investigation. The mortality in patients developing VSD after MI is high. In the Global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries (GUSTO) trial, overall 30-day mortality was 74 % and one-year mortality 78 % in patients with VSD. Surgical repair is known to be complex due to the friable myocardium associated with the VSD and debate persists about the optimal time of intervention. Closure is still considered to be the treatment of choice due to the high mortality rates associated with medically managed VSDs. The American College of Cardiology/American Heart Association guidelines recommend insertion of an intra-aortic balloon pump and referral for urgent surgery. Percutaneous closure of VSDs has been described in the congenital heart disease and ischaemic populations for a number of years. Most percutaneous procedures do not completely abolish left to right shunting, although all report an improvement in patient symptoms and haemodynamics. There is a suggestion from the published series that later closure may be associated with better survival, but there are issues around selection bias. Post-MI VSDs remain a serious life-threatening complication. Treatment options for this condition are difficult and limited. Surgical and percutaneous approaches still retain a significant mortality risk. The optimal timing of treatment remains unclear, with guidelines recommending early intervention whereas published data suggest better outcomes with a delayed approach.

• #36 Ventricular Septal Defect – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470330/

  Color Doppler transthoracic echocardiography (TTE) is the most valuable diagnostic tool for VSDs due to its high sensitivity, detecting up to 95% of cases, particularly for nonapical lesions larger than 5 mm. […] When conventional TTE results are inconclusive, transesophageal echocardiography is recommended for further evaluation. […] Electrocardiography (ECG) results are normal in about half of patients with VSD. […] Chest radiography usually appears normal in individuals with minor defects. […] Cardiac magnetic resonance imaging (MRI) and computed tomography (CT) are beneficial for evaluating complex anatomy, such as VSDs associated with other congenital heart anomalies or defects located in unusual areas that are difficult to visualize with conventional TTE. […] Cardiac catheterization is a vital diagnostic tool that provides accurate hemodynamic information, particularly regarding pulmonary vascular resistance and the response to vasodilators.

• #37 Ventricular Septal Defects: A Review | IntechOpen

  https://www.intechopen.com/chapters/81658

  Ventricular septal defects (VSDs) account for up to 30% of all congenital cardiac anomalies and are one of the most common lesions encountered in day-to-day practice. […] Echocardiography remains the main modality of definitive diagnosis for isolated defects. […] In current times, transthoracic echocardiogram (TTE) is the main modality for definitive diagnosis of VSDs. It allows to delineate size and location of the defect as well as other details such as outflow tracts, associated lesions, evidence of chamber dilation and pressures. […] Advanced imaging such as cardiac magnetic resonance (CMR) imaging is not necessary in the routine evaluation of isolated VSDs. However, it is a helpful adjunct in the diagnosis of complex anatomical variants and in the evaluation of associated defects or complications such as double chambered right ventricle and pulmonary arterial hypertension (PAH). […] Although a mainstay in diagnosis of all congenital heart defects in the past, cardiac catheterization is now reserved for cases requiring measurements of PVR.

• #38 Ventricular Septal Defect (VSD) | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/v/vsd

  Infants with moderate or large ventricular septal defects will need to have at least one echocardiogram to provide the cardiologist with a complete picture of the defect. […] In some children with ventricular septal defects, a cardiac catheterization is needed. This can help the cardiologist determine how much blood flow is going out to the lungs.

• #39 Ventricular septal defect (VSD) – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ventricular-septal-defect/diagnosis-treatment/drc-20353501

  Chest X-ray. A chest X-ray shows the condition of the heart and lungs. It can tell if the heart is enlarged and if the lungs have extra fluid. […] Pulse oximetry. A sensor placed on the fingertip records the amount of oxygen in the blood. Too little oxygen may be a sign of a heart or lung problem. […] Cardiac catheterization. In this test, a thin, flexible tube (catheter) is inserted into a blood vessel at the groin or arm and guided through the blood vessels into the heart. Through cardiac catheterization, doctors can diagnose congenital heart defects and determine the function of the heart valves and chambers. […] Cardiac magnetic resonance imaging (MRI) scan. Magnetic fields and radio waves are used to create detailed images of the heart. A health care provider might request this test if more information is needed after an echocardiogram. […] Computerized tomography (CT) scan. A series of X-rays create detailed images of the heart. It may be done if an echocardiogram didn’t provide as much information as needed.

• #40 Ventricular Septal Defect (VSD)

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/ventricular-septal-defect-vsd

  A ventricular septal defect (VSD) occurs when there is direct communication between the left and right ventricles. […] Diagnosis is predominantly made via echocardiography which directly images the shunt and can can measure important hemodynamic parameters such as cardiac chamber sizes, the Qp/Qs ratio and pulmonary pressures. […] During right heart catheterization, oxygen saturations are frequently measured from different cardiac chambers in order to identify left to right shunts. If a ventricular septal defect is present, the oxygen saturation will be markedly higher in the right ventricle due to shunting of well oxygenated blood from the left ventricle to the right ventricle. This diagnostic technique can be helpful when a patient presents after an acute myocardial infarction with pulmonary edema and shock to diagnose an acute ventricular septal defect.

• #41 Ventricular Septal Defects Differential Diagnoses

  https://emedicine.medscape.com/article/892980-differential

  In addition to the conditions listed in the differential diagnosis of ventricular septal defect (VSD), also consider VSD with associated defects and atrioventricular (AV) septal defect. […] Diagnostic Considerations […] Workup […] Radiography […] Echocardiography […] Magnetic Resonance Imaging […] Electrocardiography.

• #42 Diagnosis and Management of Ventricular Septal Defects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11607469/

  This review addresses the diagnosis and management of ventricular septal defects (VSDs). […] While initial diagnostic approaches such as careful history-taking, physical examination, chest X-rays, and electrocardiograms provide basic information, echo-Doppler studies are essential for assessing the defect’s clinical significance and determining the need for intervention. […] The size of the VSD largely determines the need for intervention. […] Initial management should focus on addressing CHF, if present, followed by surgical or transcatheter closure, as appropriate. […] Echocardiography proves invaluable not only in diagnosing VSDs but also in quantifying their size and the appropriate determining indications for closure by surgical or transcatheter methods. […] Surgical closure of perimembranous, supracristal, and inlet VSDs is generally recommended.

• #43 Diagnosis and Management of Ventricular Septal Defects

  https://www.imrpress.com/journal/RCM/25/11/10.31083/j.rcm2511411/htm

  This review addresses the diagnosis and management of ventricular septal defects (VSDs). […] While initial diagnostic approaches such as careful history-taking, physical examination, chest X-rays, and electrocardiograms provide basic information, echo-Doppler studies are essential for assessing the defect’s clinical significance and determining the need for intervention. […] The size of the VSD largely determines the need for intervention. […] For patients with moderate to large VSDs, intervention is necessary. […] The time line may be expedited to approximately six months for infants with Down syndrome due to their increased risk of developing PVOD. […] The safety of surgical repair of VSDs is well documented with a mortality rate of less than 1 to 3%. […] The indications for reintervention in cases of residual defects are generally similar to those of native defects addressed above.

• #44 Ventricular Septal Defect – Management – TeachMePaediatrics

  https://teachmepaediatrics.com/cardiology/congenital-heart-defects/ventricular-septal-defect/

  Ventricular Septal Defect (VSD) is the most common congenital heart defect (CHD) (1). VSD is defined as a condition where there is a hole in the septum separating the left and right ventricles. It can occur as an isolated lesion or alongside other CHDs. […] VSD occurs in approximately 50% of all children with a CHD and in 20% as an isolated lesion (3). The prevalence of an isolated VSD is, on average, 4.2 per 1000 births (4). Studies show that the prevalence of VSD has increased significantly in recent decades, shown to be primarily due to improved diagnosis. […] The size of the defect is the main determinant of the haemodynamic consequences of the VSD: […] Moderate sized VSD: The flow of blood through the VSD is great enough to cause a significant increase in blood flow through the pulmonary circulation.

• #45 Ventricular Septal Defect – Management – TeachMePaediatrics

  https://teachmepaediatrics.com/cardiology/congenital-heart-defects/ventricular-septal-defect/

  Large VSDs: A significant amount of blood is passing from the left to the right ventricle, and so these patients develop early heart failure and severe pulmonary hypertension. Symptoms of cardiac failure are evident after the first weeks of life, when the initially high pulmonary artery pressures drop, allowing more blood to shunt through the defect and into the lungs and thus creating pulmonary plethora. […] The history and clinical presentation of a patient with VSD depends mainly on the size of the lesion: […] Moderate VSD: Babies may have excessive sweating, become easily fatigued, and have tachypnoea (rapid breathing). […] Large VSD: Babies can demonstrate similar symptoms to congestive heart failure. The baby can present with shortness of breath, problems feeding, developmental issues regarding weight and height, and may have frequent chest infections.

• #46 Ventricular Septal Defects: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/ventricular-septal-defect-pro

  Ventricular septal defect (VSD) is the persistence of one or more holes in the septum that separates the left and right ventricles of the heart. […] The clinical presentation varies with the severity of the lesion: […] With a small VSD, the infant or child is asymptomatic with normal feeding and weight gain and the lesion may be detected when a murmur is heard at a routine examination. […] With a moderate-to-large VSD, although the babies are well at birth, symptoms generally appear by 5-6 weeks of age. […] The main symptom is exercise intolerance and since the only exercise babies do is feeding, the first impact is on feeding. […] Poor weight gain is a good indicator of heart failure in a baby. […] With very large VSDs the features are similar but more severe. […] The ECG is usually normal in patients with small VSDs.

• #47 Ventricular Septal Defect – Management – TeachMePaediatrics

  https://teachmepaediatrics.com/cardiology/congenital-heart-defects/ventricular-septal-defect/

  Large VSDs: A significant amount of blood is passing from the left to the right ventricle, and so these patients develop early heart failure and severe pulmonary hypertension. Symptoms of cardiac failure are evident after the first weeks of life, when the initially high pulmonary artery pressures drop, allowing more blood to shunt through the defect and into the lungs and thus creating pulmonary plethora. […] The history and clinical presentation of a patient with VSD depends mainly on the size of the lesion: […] Moderate VSD: Babies may have excessive sweating, become easily fatigued, and have tachypnoea (rapid breathing). […] Large VSD: Babies can demonstrate similar symptoms to congestive heart failure. The baby can present with shortness of breath, problems feeding, developmental issues regarding weight and height, and may have frequent chest infections.

• #48 Ventricular Septal Defects: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/ventricular-septal-defect-pro

  Ventricular septal defect (VSD) is the persistence of one or more holes in the septum that separates the left and right ventricles of the heart. […] The clinical presentation varies with the severity of the lesion: […] With a small VSD, the infant or child is asymptomatic with normal feeding and weight gain and the lesion may be detected when a murmur is heard at a routine examination. […] With a moderate-to-large VSD, although the babies are well at birth, symptoms generally appear by 5-6 weeks of age. […] The main symptom is exercise intolerance and since the only exercise babies do is feeding, the first impact is on feeding. […] Poor weight gain is a good indicator of heart failure in a baby. […] With very large VSDs the features are similar but more severe. […] The ECG is usually normal in patients with small VSDs.

• #49 Ventricular Septal Defects: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/ventricular-septal-defect-pro

  With a moderate VSD, left ventricular hypertrophy (LVH) and occasionally left atrial hypertrophy (LAH) may be seen. […] With large VSDs the ECG shows biventricular hypertrophy (BVH) with or without LAH. […] Transthoracic two-dimensional and Doppler echocardiography can identify the number, size and exact location of the defect. […] Management in the infant and child depends on symptoms, with small asymptomatic defects needing no medical management, and unlikely to need any intervention. […] Surgical repair is required if there is uncontrolled heart failure, including poor growth. […] Most defects are closed nowadays by directly placing a patch from the right ventricular side, usually with the surgeon working through the tricuspid valve. […] The prognosis for a patient with an isolated VSD is excellent. […] Spontaneous closure is common in children under 1 year old but less likely after the age of 2 years. […] In those needing surgery the surgical outcome is excellent and most units report a surgical mortality approaching zero.

• #50 Ventricular septal defect | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ventricular-septal-defect-1?lang=us

  Ventricular septal defects (VSD) represent a hole or pathway in the interventricular septum that allows for communication between the right and left ventricles. It typically results in a left-to-right shunt. […] Clinical presentation varies depending on the size and resultant severity of the VSD. Small lesions with minimal shunting may be asymptomatic, however, may have a loud harsh pansystolic murmur heard on precordial auscultation over the left sternal border. Larger lesions, in comparison, may cause signs of heart failure such as exertional dyspnea, raised jugular venous pressure, hepatomegaly, peripheral edema, or failure to thrive in pediatric patients, but may have a very soft murmur. […] While small VSDs will remain electrocardiographically occult, larger defects will classically demonstrate some of the following features: left atrial enlargement, high left ventricular voltage (HLVV), prominent, biphasic RS complexes (V2-V4) with amplitudes 50 mm.

• #51 Ventricular septal defect | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ventricular-septal-defect-1?lang=us

  A chest radiograph can be normal with a small VSD. Larger VSDs may show cardiomegaly (particularly left atrial enlargement although the right and left ventricle can also be enlarged). A large VSD may also show features of pulmonary arterial hypertension, pulmonary edema, pleural effusion, and increased pulmonary vascular markings. […] Allows direct visualization of the septal defect; a transthoracic parasternal short axis at the level of the aortic valve is typically the view of choice for differentiation between supracristal and perimembranous defects, whereas apical and subcostal windows are preferred for muscular defects. […] The prognosis is good for small VSDs which show a high spontaneous intrauterine or postnatal closure rate. VSDs usually do not cause any hemodynamic compromise in utero due to the right and left ventricular pressures being very similar during that period.

• #52 Ventricular Septal Defect (VSD): Types & Causes

  https://my.clevelandclinic.org/health/diseases/17615-ventricular-septal-defects-vsd

  The majority of VSDs are too small to cause any kind of problem. In those cases, a healthcare provider will watch for symptoms and see if the defect closes by itself. […] For moderate or large VSDs, your child’s provider will likely recommend a VSD procedure or surgery to close the hole. […] Repair of a large ventricular septal defect before age 2 can prevent damage to your child’s heart and lungs. […] The two main ways to repair a ventricular septal defect are: Surgery. A cardiac surgeon will patch or close a VSD. […] In either case, your child’s heart tissue will grow over and around the patch or device, which will become part of their heart wall. […] Symptoms of a VSD usually decrease or disappear after surgery or transcatheter repairs. […] In cases of a moderate or large VSD, repair of the hole is usually enough to prevent complications.

• #53 Diagnosis and Management of Ventricular Septal Defects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11607469/

  This review addresses the diagnosis and management of ventricular septal defects (VSDs). […] While initial diagnostic approaches such as careful history-taking, physical examination, chest X-rays, and electrocardiograms provide basic information, echo-Doppler studies are essential for assessing the defect’s clinical significance and determining the need for intervention. […] The size of the VSD largely determines the need for intervention. […] Initial management should focus on addressing CHF, if present, followed by surgical or transcatheter closure, as appropriate. […] Echocardiography proves invaluable not only in diagnosing VSDs but also in quantifying their size and the appropriate determining indications for closure by surgical or transcatheter methods. […] Surgical closure of perimembranous, supracristal, and inlet VSDs is generally recommended.

• #54 Ventricular Septal Defect – Management – TeachMePaediatrics

  https://teachmepaediatrics.com/cardiology/congenital-heart-defects/ventricular-septal-defect/

  Though many babies born with a small VSD won’t need surgery to close the hole, those with medium or large VSDs which are causing significant symptoms, or smaller VSDs that could possibly cause complications in later life, may need surgery to close the defect. […] In adults, the guidelines recommend that surgical closure of a VSD is indicated when there is a Qp/Qs (pulmonary-to-systemic blood flow ratio) of 2.0 or more (8). […] Echocardiography: The gold standard for confirmation of diagnosis. Size, location and severity as well as relation to nearby valves can be determined using this investigation. […] The prognosis for patients with an isolated VSD is excellent. 75% of small VSDs and especially the ones located in the muscular part of the interventricular septum, close spontaneously by the age of 10 years (11) and adults with closed VSD are expected to have a normal lifespan (12).

• #55 Ventricular Septal Defect – Management – TeachMePaediatrics

  https://teachmepaediatrics.com/cardiology/congenital-heart-defects/ventricular-septal-defect/

  Though many babies born with a small VSD won’t need surgery to close the hole, those with medium or large VSDs which are causing significant symptoms, or smaller VSDs that could possibly cause complications in later life, may need surgery to close the defect. […] In adults, the guidelines recommend that surgical closure of a VSD is indicated when there is a Qp/Qs (pulmonary-to-systemic blood flow ratio) of 2.0 or more (8). […] Echocardiography: The gold standard for confirmation of diagnosis. Size, location and severity as well as relation to nearby valves can be determined using this investigation. […] The prognosis for patients with an isolated VSD is excellent. 75% of small VSDs and especially the ones located in the muscular part of the interventricular septum, close spontaneously by the age of 10 years (11) and adults with closed VSD are expected to have a normal lifespan (12).

• #56 Ventricular Septal Defect (VSD) | University of Utah Health

  https://healthcare.utah.edu/cardiovascular/conditions/ventricular-septal-defect

  It’s important to ask your doctor about the long-term outlook for your child. Outcomes are usually excellent when VSD is diagnosed early. Outcomes are worse for children who are diagnosed with VSD when they’re older. This is because older children may have complications after surgery. It’s also harder for doctors to fix VSD in older children.

• #57 Ventricular Septal Defect – Management – TeachMePaediatrics

  https://teachmepaediatrics.com/cardiology/congenital-heart-defects/ventricular-septal-defect/

  Though many babies born with a small VSD won’t need surgery to close the hole, those with medium or large VSDs which are causing significant symptoms, or smaller VSDs that could possibly cause complications in later life, may need surgery to close the defect. […] In adults, the guidelines recommend that surgical closure of a VSD is indicated when there is a Qp/Qs (pulmonary-to-systemic blood flow ratio) of 2.0 or more (8). […] Echocardiography: The gold standard for confirmation of diagnosis. Size, location and severity as well as relation to nearby valves can be determined using this investigation. […] The prognosis for patients with an isolated VSD is excellent. 75% of small VSDs and especially the ones located in the muscular part of the interventricular septum, close spontaneously by the age of 10 years (11) and adults with closed VSD are expected to have a normal lifespan (12).

• #58 Ventricular Septal Defects: Symptoms, and Treatment | Doctor

  https://patient.info/doctor/ventricular-septal-defect-pro

  With a moderate VSD, left ventricular hypertrophy (LVH) and occasionally left atrial hypertrophy (LAH) may be seen. […] With large VSDs the ECG shows biventricular hypertrophy (BVH) with or without LAH. […] Transthoracic two-dimensional and Doppler echocardiography can identify the number, size and exact location of the defect. […] Management in the infant and child depends on symptoms, with small asymptomatic defects needing no medical management, and unlikely to need any intervention. […] Surgical repair is required if there is uncontrolled heart failure, including poor growth. […] Most defects are closed nowadays by directly placing a patch from the right ventricular side, usually with the surgeon working through the tricuspid valve. […] The prognosis for a patient with an isolated VSD is excellent. […] Spontaneous closure is common in children under 1 year old but less likely after the age of 2 years. […] In those needing surgery the surgical outcome is excellent and most units report a surgical mortality approaching zero.

• #59 Diagnosis and Management of Ventricular Septal Defects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11607469/

  This review addresses the diagnosis and management of ventricular septal defects (VSDs). […] While initial diagnostic approaches such as careful history-taking, physical examination, chest X-rays, and electrocardiograms provide basic information, echo-Doppler studies are essential for assessing the defect’s clinical significance and determining the need for intervention. […] The size of the VSD largely determines the need for intervention. […] Initial management should focus on addressing CHF, if present, followed by surgical or transcatheter closure, as appropriate. […] Echocardiography proves invaluable not only in diagnosing VSDs but also in quantifying their size and the appropriate determining indications for closure by surgical or transcatheter methods. […] Surgical closure of perimembranous, supracristal, and inlet VSDs is generally recommended.

• #60

  https://journals.lww.com/jiae/fulltext/2020/04030/ventricular_septal_defect__echocardiography.7.aspx

  In a patient with a small VSD, clinical feature of loud pansystolic murmur is the only reason for echocardiographic evaluation. […] Determination of the size of VSD is made on hemodynamic basis like degree of left-to-right shunt, presence of volume overload, and pulmonary artery pressure. […] Integration of spectral and color Doppler with 2D echocardiography greatly assists with identification and characterization of VSDs. […] Surgical closure of VSD remains the treatment of choice for large defects with good long-term results and quality of life. […] An echocardiographer must provide a clear understanding of VSD to a surgeon for planning of surgery including size, location, number of defects, and relationship with surrounding cardiac structures. […] More recently, transcatheter device closure and hybrid approach has developed as an alternate to surgical closure in carefully selected cases.

• #61 Ventricular Septal Defect (VSD): Types & Causes

  https://my.clevelandclinic.org/health/diseases/17615-ventricular-septal-defects-vsd

  The majority of VSDs are too small to cause any kind of problem. In those cases, a healthcare provider will watch for symptoms and see if the defect closes by itself. […] For moderate or large VSDs, your child’s provider will likely recommend a VSD procedure or surgery to close the hole. […] Repair of a large ventricular septal defect before age 2 can prevent damage to your child’s heart and lungs. […] The two main ways to repair a ventricular septal defect are: Surgery. A cardiac surgeon will patch or close a VSD. […] In either case, your child’s heart tissue will grow over and around the patch or device, which will become part of their heart wall. […] Symptoms of a VSD usually decrease or disappear after surgery or transcatheter repairs. […] In cases of a moderate or large VSD, repair of the hole is usually enough to prevent complications.

• #62

  https://journals.lww.com/jiae/fulltext/2020/04030/ventricular_septal_defect__echocardiography.7.aspx

  In a patient with a small VSD, clinical feature of loud pansystolic murmur is the only reason for echocardiographic evaluation. […] Determination of the size of VSD is made on hemodynamic basis like degree of left-to-right shunt, presence of volume overload, and pulmonary artery pressure. […] Integration of spectral and color Doppler with 2D echocardiography greatly assists with identification and characterization of VSDs. […] Surgical closure of VSD remains the treatment of choice for large defects with good long-term results and quality of life. […] An echocardiographer must provide a clear understanding of VSD to a surgeon for planning of surgery including size, location, number of defects, and relationship with surrounding cardiac structures. […] More recently, transcatheter device closure and hybrid approach has developed as an alternate to surgical closure in carefully selected cases.

• #63 Diagnosis and Management of Ventricular Septal Defects

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11607469/

  While transcatheter closure of perimembranous VSDs with Amplatzer Membranous VSD Occluder is technically feasible, it is not endorsed due to concerns regarding the potential for inducing complete heart block, a complication observed in a substantial number of patients. […] However, percutaneous and hybrid methods exist to close large muscular VSDs with Amplatzer Muscular VSD Occluder and generally yield favorable outcomes.

• #64 Diagnosis and Management of Ventricular Septal Defects

  https://www.imrpress.com/journal/RCM/25/11/10.31083/j.rcm2511411/htm

  The diagnosis and management of VSDs was comprehensively reviewed in this paper. […] Echocardiography proves invaluable not only in diagnosing VSDs but also in quantifying their size and the appropriate determining indications for closure by surgical or transcatheter methods. […] While transcatheter closure of perimembranous VSDs with Amplatzer Membranous VSD Occluder is technically feasible, it is not endorsed due to concerns regarding the potential for inducing complete heart block, a complication observed in a substantial number of patients. […] In conclusion, while the majority of the treatment alternatives examined have demonstrated adequate results, it is crucial to exercise caution in the management of small defects to avoid unnecessary interventions.

• #65 Ventricular Septal Defect (VSD) | University of Utah Health

  https://healthcare.utah.edu/cardiovascular/conditions/ventricular-septal-defect

  It’s important to ask your doctor about the long-term outlook for your child. Outcomes are usually excellent when VSD is diagnosed early. Outcomes are worse for children who are diagnosed with VSD when they’re older. This is because older children may have complications after surgery. It’s also harder for doctors to fix VSD in older children.

• #66 Ventricular Septal Defect (VSD) | Loma Linda University Children’s Health

  https://lluch.org/conditions/ventricular-septal-defect-vsd

  A cardiac MRI makes images of the body by using magnets and radio waves. It can show the heart defect and how much blood flow is moving through the VSD. […] Your child’s healthcare provider will decide when and how your child’s VSD will be fixed. […] Your child’s healthcare team will give you information and support so you can care for them at home. […] Most children who have surgery for VSD will live normal, healthy lives. […] The outlook may be poor when a VSD is diagnosed later in life, if complications occur after surgery, or if the VSD isn’t fixed.

• #67 Ventricular septal defect (VSD) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ventricular-septal-defect/symptoms-causes/syc-20353495

  Complications of ventricular septal defect can include: Heart failure. In a heart with a medium or large VSD, the heart works harder and the lungs have too much blood pumped to them. Without treatment, heart failure can develop. […] A small ventricular septal defect (VSD) may never cause any problems. Some medium or large VSDs may be life-threatening. Treatment can help prevent many complications.

• #68 Pediatric Ventricular Septal Defect (VSD) – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/ventricular-septal-defect-vsd

  An echo uses sound waves to make a moving picture of the heart and heart valves. This test can show the pattern and amount of blood flow through the septal opening. An echo is used to diagnose VSD. […] Treatment will depend on your childs symptoms, age and general health. It will also depend on how severe the condition is. […] A larger VSD often needs to be fixed with surgery or through cardiac catheterization. […] The goal of surgery is to close the septal opening before the lungs are damaged. […] VSD may be fixed by a cardiac catheterization. […] Complications of an untreated ventricular septal defect include: Lung problems, Heart failure, Irregular heart rhythms (arrhythmias), Heart valve problems, Poor growth and development. […] If the VSD is moderate to severe, your childs heart doctor will closely monitor him or her. The doctor will decide when and how your childs ventricular septal defect will be fixed. […] Most children who have surgery for VSD will live normal, healthy lives. Their activity levels, appetite, and growth often return to normal. […] When this condition is diagnosed early, the outcome is often excellent.

• #69 Ventricular Septal Defect – ACHA

  https://www.achaheart.org/your-heart/educational-qas/types-of-heart-defects/ventricular-septal-defect/

  If you have a VSD, it is important that you see an ACHD doctor as recommended to make sure your heart stays healthy. […] Most VSDs are closed by placing a patch or plug into the hole during open heart surgery. […] Experts recommend that all adults with CHD be seen once at an ACHD center to make sure that the diagnosis is correct and the repair is still working.

• #70 Ventricular Septal Defect (VSD): Diagnosis and Treatment

  https://www.massgeneral.org/children/ventricular-septal-defect/diagnosis-treatment

  How is ventricular septal defect (VSD) diagnosed? Your child will see a pediatric cardiologist (heart doctor). During that visit, they will have the following tests: Electrocardiogram (EKG). An EKG helps doctors learn more about your child’s heart rate and rhythm. Echocardiogram (echo). An echo is an ultrasound of the heart. It lets the doctors know how the heart is working. The care team will go over the test results with you on the same day. […] Will my child need follow-up care? Yes. The Pediatric Cardiology team will help guide you through your child’s specific care plan.

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