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Cardio Exam
 
 

Ventricular Septal Defect

 
 
 
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Overview

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.
  • Causes of Ventricular Septal Defect

  • Congenital - associated with Down syndrome
  • Acquired - septal myocardial infarction, iatrogenic
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