Ventricular Septal Defect (VSD)

Outline

Background 

• 0.1% of live births & 30% of congenital heart defects

Assessment

Presentation

• Newborn (larger): hypoxia, failure to thrive, 

• Adult (smaller): asymptomatic 

Examination

• Pansystolic murmur

Investigations

• ECHO: size & location of hole & pulmonary pressures

• CXR, ECG- normal if small; cardiac decompensation in large

Diagnosis

Diagnostic criteria: transthoracic ECHO confirmation

Classified by size and location. 

Differentials: systolic murmur: AS, MR, HOCM, PS, TR

Management

By size:

• Larger lesions in newborns will cause cyanosis, pulmonary HTN, Eisenmenger Syndrome and death; therefore require surgical correction

• Intermediate lesions may require monitoring

• Smaller lesions may self close by themselves

References

1. Ventricular septal defect (VSD): What is it, types, causes & symptoms (2024) Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/17615-ventricular-septal-defects-vsd (Accessed: 27 September 2024).

2. https://www.bhf.org.uk/informationsupport/conditions/ventricular-septal-defect

3. https://www.rcemlearning.co.uk/modules/congenital-heart-disease-in-the-emergency-department/lessons/lefttoright-shunts/topic/ventricular-septal-defect-vsd/

Page written in 2026.