Ventricular Septal Defects: Clinical Case and Viva QnA
Clinical Case of Ventricular Septal Defect
A 3-month-old female infant is brought to the pediatric clinic by her parents for a routine checkup. The parents report that the baby seems to tire easily during feeding and has not been gaining weight as expected. On examination, the pediatrician notes the following:
- Weight: 4.2 kg (below the 3rd percentile for age)
- Respiratory rate: 60 breaths/min
- Heart rate: 140 beats/min
- Blood pressure: 80/50 mmHg
- Oxygen saturation: 94% on room air
On auscultation, a grade 3/6 pansystolic murmur is heard best at the left lower sternal border. The liver edge is palpable 2 cm below the right costal margin. Chest X-ray shows cardiomegaly and increased pulmonary vascularity. Echocardiography confirms a large perimembranous ventricular septal defect with left-to-right shunting.
The infant is diagnosed with a hemodynamically significant VSD and is referred to a pediatric cardiologist for further management and consideration of surgical repair.
Varieties of Presentation of Ventricular Septal Defects
- Asymptomatic Presentation: Small VSDs may be detected incidentally during routine physical examination when a heart murmur is heard. The child has normal growth and development with no symptoms.
- Failure to Thrive: Infants with moderate to large VSDs may present with poor weight gain, fatigue during feeding, and increased respiratory effort due to increased pulmonary blood flow and heart failure.
- Recurrent Respiratory Infections: Children with VSDs may have increased susceptibility to respiratory infections due to pulmonary overcirculation. They may present with frequent episodes of pneumonia or bronchiolitis.
- Eisenmenger Syndrome: In rare cases of large, unrepaired VSDs, patients may present later in childhood or adolescence with cyanosis, clubbing of fingers, and exercise intolerance due to the development of pulmonary hypertension and reversal of shunt direction.
- Acute Presentation: Rarely, a VSD associated with acute bacterial endocarditis may present with fever, new or changing heart murmur, and signs of systemic embolization such as stroke or splenic infarction.
VSD Quiz for Medical Students & Professionals
This interactive quiz component covers essential concepts about Ventricular Septal Defects (VSD) in pediatric cardiology. It includes 25 high-yield viva questions with detailed answers
Image Gallery
These medical images are collected from various internet sources for educational purposes. Each image includes a source link; by clicking the source, you will be taken to the corresponding source website page.
Ventricular septal defec- Color Dopler
The cross-sectional echocardiogram, taken in slightly off axis four chamber projections, shows an apical muscular ventricular septal defect (white arrow) in the left hand panel of Figure13a. The right hand panel shows the Doppler color flow map of a hemodynamically restrictive muscular ventricular septal defect. The apical five chamber view, shown in Figure 13b, shows the Doppler color flow map of an apical muscular ventricular septal defect (white arrow).(source)
VSD in Infants of diabetic mother
Ventricular septal defect (VSD): Cardiomegaly with plethoric lungs and an inconspicuous aortic knuckle in an infant with ventricular septal defect.(source)
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