A hole in the septum between the ventricles (lower heart chambers), allowing blood to flow from left to right.
Types:
- Small VSD
→ Murmur, but no major symptoms (may close on its own).
- Large VSD
→ Heart failure, Eisenmenger’s syndrome (serious
complications).
Most Common Congenital Heart Defect! (1 in 500 live births)
CAUSES OF VSD
• Congenital (Present from birth) → Due to incomplete
septum formation during fetal development.
• Acquired (Rarely) → Heart attack (MI rupture),
Trauma.
Mnemonic: "VSD = Ventricular Septum Defect"
SYMPTOMS OF VSD
• Small VSD (Mild or No Symptoms)
- Loud murmur (Pansystolic) →
"Maladie de Roger"
- Normal growth & development
• Large VSD (Severe Symptoms)
- Heart Failure in Babies (Tachypnea,
Sweating, Poor Feeding)
- Recurrent Chest Infections
- Cyanosis (if untreated, due to
Eisenmenger’s Syndrome)
Mnemonic: "VSD = Very Small or Dangerous" (Mild vs. Severe Symptoms)
HEART MURMUR IN
VSD
- Pansystolic (Holosystolic) Murmur → Heard best at the left sternal edge
- Small VSD → Loud Murmur (Because of high-pressure flow)
- Large VSD → Soft Murmur (Due to equalized pressures)
Mnemonic: "Small Hole = LOUD, Big Hole = SOFT"
COMPLICATIONS OF
VSD
• Heart Failure (Excessive blood flow to lungs → overloads
heart)
• Eisenmenger’s Syndrome (Shunt reversal → Cyanosis, Clubbing)
• Pulmonary Hypertension
• Endocarditis (Infection in Heart)
Mnemonic: "HEEP" (VSD Complications)
- Heart
Failure
- Eisenmenger’s
Syndrome
- Endocarditis
- Pulmonary
Hypertension
DIAGNOSIS OF VSD
- Chest X-ray → Shows enlarged heart, increased lung blood flow
- ECG → Right & Left Ventricular Hypertrophy (if severe)
- Echocardiography (ECHO – Best Test!) → Confirms size & location of defect
- Color Doppler → Detects exact shunt flow
Mnemonic: "ECHO-X" (Tests for VSD)
- ECHO → Confirms
Diagnosis
- Chest X-ray
→ Checks Heart Size
- Holter
Monitor → If Arrhythmia is Suspected
- Oxygen
Saturation (Pulse Oximetry)
TREATMENT OF VSD
1. SMALL VSD
No treatment needed! (Most close by 2-5 years)
Endocarditis Prophylaxis (Prevent infection)
2. LARGE VSD
(With Heart Failure)
Medications:
- Diuretics (Furosemide)
→ Reduce excess fluid
- Digoxin
→ Strengthens heart contraction
Surgery:
- Indicated if Symptoms Persist
(By age 1-2 years)
- Options:
- Open-heart surgery (Patch Closure)
- Catheter-based Closure (Less invasive,
for small-moderate defects)
Mnemonic: "DOP" (Drugs for VSD)
- Diuretics
- Oxygen &
Digoxin
- Prophylaxis
for Endocarditis
EISENMENGER'S
SYNDROME (SEVERE UNTREATED VSD)
What happens?
- Left-to-Right Shunt Reverses → Becomes
Right-to-Left
- Cyanosis & Clubbing Develop
- Pulmonary Hypertension (Irreversible)
Signs:
- Blue Skin (Cyanosis)
- Clubbing of Fingers & Toes
- Loud P2 Sound on Heart Exam
Treatment:
- Heart-Lung Transplant (Only cure!)
- Avoid Surgery if Eisenmenger’s is
Fully Developed
Mnemonic: "VSD → Eisenmenger = Very Serious Disease"
PROGNOSIS OF VSD
- Small VSD → Excellent Outcome (Most close by age 5)
- Large VSD → Good if Treated Early
- Eisenmenger’s Syndrome → Poor Outcome Without Transplant
Mnemonic: "VSD = Very Small or Dangerous"
FINAL REVISION WITH MNEMONICS
- VSD = "Ventricular Septum Defect" (Hole in Ventricles)
- Symptoms = "VSD = Very Small or Dangerous" (Small = Loud Murmur, Large = Heart Failure)
- Murmur = "Small Hole = LOUD, Big Hole = SOFT"
- Complications = "HEEP" (Heart Failure, Eisenmenger, Endocarditis, Pulmonary HTN)
- Diagnosis = "ECHO-X" (ECHO, X-ray, Holter, Oxygen Check)
- Treatment = "DOP" (Diuretics, Oxygen/Digoxin, Prophylaxis)
