![]() ![]() Unprotected lungs with large shunts invariably lead to pulmonary vascular disease and severe pulmonary hypertension (Eisenmenger physiology). The presentation in adults is dependent on the size of the shunt and whether there is associated pulmonic or subpulmonic stenosis that has protected the lung from the systemic pressure and volume. The smaller the defect, the greater the gradient from the LV to the RV and the louder the murmur. ![]() A left-to-right shunt is present unless there is associated RV hypertension. Membranous and muscular septal defects may spontaneously close in childhood as the septum grows and hypertrophies. ![]() Four types are often described: in type A, the VSD lies underneath the semilunar valves in type B, the VSD is membranous with three variations in type C, the inlet VSD is present below the tricuspid valve and often part of the AV canal defect and type D is the muscular VSD (see illustration). Congenital VSDs occur in various parts of the ventricular septum. The higher the gradient across the septum, the smaller the left-to-right shunt.ĭe novo VSDs are uncommon in adults. Larger defects may result in pulmonary hypertension (Eisenmenger physiology) if not repaired.Ī grade II–VI/VI pansystolic murmur maximal at the left sternal border is heard an associated thrill is common.ĮCG may show LVH, RVH, or both radiograph shows increased pulmonary vascularity, and increased PA and LA size.Įchocardiography/Doppler is diagnostic. A restrictive VSD is small and makes a louder murmur than an unrestricted one. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |