Ventricular septal defect - Revision history

Rossdonaldson1: /* Differential Diagnosis */

2024-11-06T18:53:42Z

Differential Diagnosis

← Older revision		Revision as of 18:53, 6 November 2024
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Aortic stenosis]]		===Non-Congenital Presentations===
	*[[Tricuspid regurgitation]]		*[[Tricuspid regurgitation]]
	*[[Mitral regurgitation]]		*[[Mitral regurgitation]]

2024-11-06T18:51:51Z

Differential Diagnosis

← Older revision		Revision as of 18:51, 6 November 2024
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	==Differential Diagnosis==		==Differential Diagnosis==
	*Pulmonary stenosis		*[[Aortic stenosis]]
	*[[~~Patent ductus arteriosus~~]]		*[[Tricuspid regurgitation]]
	*[[~~Tetralogy of Fallot~~]]
	*Aortic stenosis
	*Tricuspid regurgitation
	*[[Mitral regurgitation]]		*[[Mitral regurgitation]]
	*[[Hypertrophic cardiomyopathy]]		*[[Hypertrophic cardiomyopathy]]

2024-11-06T18:31:05Z

Differential Diagnosis

← Older revision		Revision as of 18:31, 6 November 2024
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	*[[Mitral regurgitation]]		*[[Mitral regurgitation]]
	*[[Hypertrophic cardiomyopathy]]		*[[Hypertrophic cardiomyopathy]]

			{{Congenital heart disease DDX}}

	==Evaluation==		==Evaluation==

2024-11-06T18:30:09Z

Evaluation

← Older revision		Revision as of 18:30, 6 November 2024
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	==Evaluation==		==Evaluation==
	[[File:Ventricular Septal Defect.jpg\|thumb\|[[Echo]] showing a moderate ventricular septal defect in the mid-muscular part of the septum. The trace in the lower left shows the flow during one complete cardiac cycle and the red mark the time in the cardiac cycle that the image was captured. Colours are used to represent the velocity of the blood. Flow is from the left ventricle (right on image) to the right ventricle (left on image). The size and position is typical for a VSD in the newborn period.]]		[[File:Ventricular Septal Defect.jpg\|thumb\|[[Echo]] showing a moderate ventricular septal defect in the mid-muscular part of the septum. Flow is from the left ventricle (right on image) to the right ventricle (left on image). The size and position is typical for a VSD in the newborn period.]]
	*[[Echocardiography]]		*[[Echocardiography]]
	**Most important clinical test		**Most important clinical test

2024-11-06T18:26:37Z

Evaluation

← Older revision		Revision as of 18:26, 6 November 2024
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	==Evaluation==		==Evaluation==
			[[File:Ventricular Septal Defect.jpg\|thumb\|[[Echo]] showing a moderate ventricular septal defect in the mid-muscular part of the septum. The trace in the lower left shows the flow during one complete cardiac cycle and the red mark the time in the cardiac cycle that the image was captured. Colours are used to represent the velocity of the blood. Flow is from the left ventricle (right on image) to the right ventricle (left on image). The size and position is typical for a VSD in the newborn period.]]
	*[[Echocardiography]]		*[[Echocardiography]]
	**Most important clinical test		**Most important clinical test

2024-11-06T18:25:01Z

Background

← Older revision		Revision as of 18:25, 6 November 2024
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	==Background==		==Background==
	[[File:VSD.jpg\|thumb\|Ventricular septal defect]]		[[File:VSD.jpg\|thumb\|Ventricular septal defect]]
			[[File:Vsd simple-lg.jpg\|thumb\|Illustration showing various forms of ventricular septal defects. 1. Conoventricular, malaligned; 2. Perimembranous; 3. Inlet; and 4. Muscular.]]
	*Defect in septum separating left and right ventricles		*Defect in septum separating left and right ventricles
	*Second most common congenital heart defect		*Second most common congenital heart defect

2019-03-19T16:23:03Z

Management

← Older revision		Revision as of 16:23, 19 March 2019
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	*40-60% require no intervention, will spontaneously close in early childhood		*40-60% require no intervention, will spontaneously close in early childhood
	*Surgical closure (often done percutaneously)		*Surgical closure (often done percutaneously)
	**~~definitive~~ treatment for defects that do not close ~~on their own~~ and cause ~~significant~~ disability		**Definitive treatment for defects that do not spontaneously close and cause disability
	*Patients with unrepaired VSDs ~~are~~ at increased risk for:		*Patients with unrepaired VSDs at increased risk for:
	**[[Endocarditis]]		**[[Endocarditis]]
	**[[Arrhythmia]]		**[[Arrhythmia]]
	***[[Premature ventricular contractions]] (PVCs)		***[[Premature ventricular contractions]] (PVCs)
	***[[~~ventricular~~ tachycardia\|Ventricular tachyarrhythmias]]		***[[Ventricular tachycardia\|Ventricular tachyarrhythmias]]
	***Sudden death		***Sudden death
	***[[Congestive heart failure]]		***[[Congestive heart failure]]
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	***[[COPD]]		***[[COPD]]
	***[[Pulmonary hypertension]]		***[[Pulmonary hypertension]]
	*Treatment is aimed at reducing complications ~~associated with the VSD~~		*Treatment aimed at reducing complications

	==Disposition==		==Disposition==

2019-03-19T16:22:06Z

Evaluation

← Older revision		Revision as of 16:22, 19 March 2019
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	**Allows operator to visualize the defect and assess how much bloodflow is crossing the defect by using color flow Doppler		**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		**Allows for detection of other possible structural defects
			**Often used to follow VSDs for spontaneous closure
	*[[EKG]]		*[[EKG]]
	**~~most~~ patients with ~~VSDs will~~ have a normal ~~EKG~~		**Most patients with have normal EKGs
	**conduction ~~delay~~ or RBBB ~~may be seen in large defects~~		**Large defects may produce conduction delays or RBBB
	*[[CXR]]		*[[CXR]]
	**~~typically~~ normal ~~in patients with VSDs~~		**Usually normal
	**~~may~~ show cardiomegaly with enlarged left ventricle and atrium		**May show cardiomegaly with enlarged left ventricle and atrium
			**May show signs of CHF

	==Management==		==Management==

2019-03-19T16:20:29Z

Clinical Presentation

← Older revision		Revision as of 16:20, 19 March 2019
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	**Best heard over the lower left sternal boarder		**Best heard over the lower left sternal boarder
	**Characterized as a holosystolic murmur		**Characterized as a holosystolic murmur
	**~~Often, the smaller the defect, the~~ louder ~~the murmur~~		**Smaller defects produce louder murmurs

	==Differential Diagnosis==		==Differential Diagnosis==

2019-03-19T16:19:32Z

Background

← Older revision		Revision as of 16:19, 19 March 2019
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	==Background==		==Background==
	[[File:VSD.jpg\|thumb\|Ventricular septal defect]]		[[File:VSD.jpg\|thumb\|Ventricular septal defect]]
	*Defect in ~~the~~ septum separating left and right ventricles		*Defect in septum separating left and right ventricles
	*Second most common congenital heart defect		*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]]		*Can be isolated, due to chromosomal abnormalities (5%), or coexist with other heart defects such as [[Tetralogy of Fallot]]
	*Clinical ~~presentation~~ vary depending on comorbid conditions		*Clinical presentations vary depending on comorbid conditions

	==Clinical Presentation==		==Clinical Presentation==