Ventricular Septal Defect VSD echo VSD view in ECHO

1. VENTRICULAR
SEPTAL DEFECT
Made By:- Muskan Kapoor

2. INTRODUCTION
● In this congenital heart disease,
interventricular septum incompletely
separates the right and left ventricle due
to a developmental defect.
● This is a acyanotic heart disease with left
to right shunt.
● The defect may be small and isolated (
maladie de roger) or may be a part of
complex congenital heart disease.
● The acquired defects in the ventricular
septum can result from rupture of an
infarcted interventricular septum as a
complication of acute myocardial
infarction.

3. PHYSICAL FEATURES
● It is mainly asymptomatic and
incidentally detected.
● It may produce symptoms of
palpitation, mild exertional dyspnea,
cough.
● The murmur may be the only
evidence of VSD.
● The clinical features are due to
volume overload or high output state.
● The blood flows from the left to right
ventricle and then to pulmonary
arteries.

4. CLINICAL SIGNS
● Good volume pulse.
● Systolic thrill across the lower part of
sternum may be present.
● ECG may show bundle branch block or
left ventricular hypertrophy.
● Chest X ray revels enlargement of heart ,
dilatation of pulmonary artery.
● Increased pulsation of pulmonary artery
fluoroscopy.
● Echocardiogram shows left ventricular
enlargement with dilation of pulmonary
artery.
● Color doppler study will detect the
defect.

5. ECHOCARDIOGRAPHY
● Evaluate type of VSD.
● Size of VSD :- small i.e. less than one third LVOT diameter.
- Moderate i.e one third to two third of LVOT diameter.
- Larger i.e. greater than two third LVOT diameter.
● Evaluate the direction of shunt :- shunting occur in systole.
- The shunting is left to right in smaller lesions with normal pulmonary
resistance.
- Volume overload is reflected by LA dilation, LVH.
- PA pressure is checked with the help of bernoulli theorem

6. BUBBLE/CONTRAST STUDIES
● It is used in determining whether there is flow across the IAS/IVS.
● This can be done with commercially available contrast agents or with
saline which has small amount of patient’s blood or air bubbles agitated
in a syringe.
● This is injected in a peripheral vein and contrast seen in RA and then
RV.
● The subject is often asked to perform a Valsalva manoeuvre to increase
intrathoracic pressure.
● Contrast may be seen shunting from RA to LA in the presence of an
ASD , PFO or RV to LV in the presence of VSD.
● A contrast study may be positive even when no obvious flow is
detected on color flow mapping