Pathogenesis
Causes of Ventricular Septal Defect
- Congenital - associated with Down syndrome
- Acquired - septal myocardial infarction, iatrogenic
Diagnosis
A ventricular septal defect, or hole in the ventricular wall, manifests as a harsh pansystolic murmur best heard over the left lower sternal edge.
Signs of Ventricular Septal Defect
Central Signs
- Volume-loaded apex beat - displaced apex with forceful, non-sustained impulses
- Soft first heart sound (S1)
- Harsh pan-systolic murmur loudest at the left lower sternal edge
Signs of Complications
- Evidence of mitral regurgitation
- Evidence of pulmonary hypertension - raised JVP, parasternal heave, loud / palpable P2
- Evidence of Eisenmenger's syndrome - cyanosis, clubbing
Smaller VSDs tend to be louder.
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