Ventricular septal defect

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Ventricular septal defect
  • Defect in septum separating left and right ventricles
  • Second most common congenital heart defect
  • Can be isolated, due to chromosomal abnormalities (5%), or coexist with other heart defects such as Tetralogy of Fallot
  • Clinical presentations vary depending on comorbid conditions

Clinical Presentation

  • Small VSDs
    • Generally asymptomatic
  • Moderate Size VSDs
    • May be asymptomatic
    • +/- heart failure symptoms in childhood or early adulthood
    • May decrease in size without intervention as patient ages
  • Large VSDs
  • VSD murmur
    • Best heard over the lower left sternal boarder
    • Characterized as a holosystolic murmur
    • Smaller defects produce louder murmurs

Differential Diagnosis


  • Echocardiography
    • Most important clinical test
    • High detection rate for VSD
    • Allows operator to visualize the defect and assess how much bloodflow is crossing the defect by using color flow Doppler
    • Allows for detection of other possible structural defects
    • Often used to follow VSDs for spontaneous closure
  • EKG
    • Most patients with have normal EKGs
    • Large defects may produce conduction delays or RBBB
  • CXR
    • Usually normal
    • May show cardiomegaly with enlarged left ventricle and atrium
    • May show signs of CHF



  • Suspected VSDs require workup by a cardiologist
  • Once surgery becomes an option, surgical consultation is recommended

See Also

External Links

  • Ventricular septal defects | circulation Retrieved 8/18/2017, 2017, from
  • Du ZD, Roguin N, Wu XJ. Spontaneous closure of muscular ventricular septal defect identified by echocardiography in neonates. Cardiol Young 1998; 8:500.