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Ventricular Septal Defect

Luay Sarsam, MD, Cherry Onaiwu, MD, MS and Carrie Valenta, MD, FACP, FHM Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Congenital or acquired defect of the interventricular septum that allows communication of blood between the left and the right ventricles

  • Second most common congenital heart malformat...

DIAGNOSIS

HISTORY

  • Presentation depends on degree of shunting across the defect; may be completely asymptomatic with small defects

  • Respiratory distress, tachypnea, tachycardia

  • Diaphoresis with feeds, poor...

TREATMENT

  • Start diuretic therapy if signs of fluid overload (1)[A].

  • Minimize IV fluids.

  • Consider ACE inhibitor and/or digoxin.

  • Nasogastric feeds for neonates

  • Correct anemia via iron supplementation or a p...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Small VSDs without evidence of CHF or pulmonary HTN generally can be followed every 1 to 5 years after the neonatal period.

  • Moderate to large VSDs require more fre...

REFERENCES

1
Faris RF, Flather M, Purcell H, et al. Diuretics for heart failure. Cochrane Database Syst Rev.  2012;(2):CD003838. [View Abstract on OvidMedline]
2
Wilson W, Taubert KA, Gewitz M, et a...

ADDITIONAL READING

Penny DJ, Vick GWIII. Ventricular septal defect. Lancet.  2011;377(9771):1103–1112. [View Abstract on OvidMedline] 

SEE ALSO

Acute Coronary Syndromes: NSTE-ACS (Unstable Angina a...

CODES

ICD10

  • Q21.0 Ventricular septal defect

  • I23.2 Ventricular septal defect as current comp following AMI

  • Q21.3 Tetralogy of Fallot

ICD9

  • 745.4 Ventricular septal defect

  • 429.71 Acquired cardiac septal defect

  • ...

CLINICAL PEARLS

  • A loud 2/6 to 3/6 low-pitched harsh holosystolic murmur at the left lower sternal border is typical.

  • A diastolic rumble at the apex indicates moderate to large VSD or ratio of pulmonary...

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