Ventricular septal defect
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Ventricular septal defect (VSD) is a defect in the wall separating the left and right ventricles of the heart. There are four main types of VSD based on location. A VSD allows blood to flow from the left ventricle to the right ventricle, overloading the right ventricle and lungs. Symptoms depend on the size of the shunt but can include heart failure, pulmonary hypertension, and abnormal heart sounds. VSDs are typically diagnosed via echocardiogram and may close on their own, though large defects often require surgical closure to prevent complications later in life. With treatment, long-term prognosis is excellent.
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1. An atrial septal defect is an opening in the septum between the left and right atria, allowing blood to shunt from the left to the right side of the heart.
2. It is one of the most common congenital heart defects found in adults.
3. Symptoms range from none in small defects to fatigue and shortness of breath from right heart strain in large defects that cause significant shunting of blood from the left to the right atrium.
Congenital heart diseases
The lecture is for medical student. It is from Dr RUSINGIZA Emmanuel, MD, senior lecture at UR( UNIVERSITY OF RWANDA) .
It will help to understand heart diseases in newborn, infants and children.
Congenital heart diseases 1
This document discusses congenital heart diseases (CHD), which are the most common type of heart disease in children. CHD can be caused by genetic factors like chromosomal abnormalities or environmental factors like infections during pregnancy. They are classified as defects causing left-to-right shunts, right-to-left shunts, or obstructions. Common examples of each type are described along with their typical presentations, morphologies, and clinical outcomes. Surgical correction or intervention is often needed for severe defects.
vsd
Ventricular septal defects (VSDs) are one of the most common types of congenital heart defects. They occur when there is an abnormal opening in the dividing wall between the lower chambers of the heart (the ventricular septum). VSDs can vary in size and location. Small, restrictive VSDs may close on their own, while larger defects can cause increased blood flow to the lungs which can lead to pulmonary hypertension if left untreated. VSDs are typically diagnosed and monitored using echocardiography. Treatment options range from observation for small defects to surgical closure for larger VSDs.
congenital heart diseases.pdf
This document summarizes congenital heart diseases (CHD). It describes that CHD results from abnormalities present at birth during heart development. The major categories are left-to-right shunts, right-to-left shunts, and obstructions. Common examples like atrial septal defects, ventricular septal defects, and patent ductus arteriosus cause left-to-right shunting, increasing pulmonary blood flow. Right-to-left shunting defects like tetralogy of Fallot cause hypoxemia. Causes include genetic factors and environmental exposures. Clinical features and treatments depend on the specific type of CHD.
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Ventricular septal defect
- 1. V E N T R I C U L A R S E P T A L D E F E C T By: Shayan Fatima Azad 1
- 2. By: Shayan Fatima Azad 2
- 3. WHAT IS VSD? • VSD is a defect in interventricular septum that allows a left to right shunting of blood. • Approximately 2-8 out of 1000 live births are affected withVSD. • They may occur separately. • They may also occur as complex set of cardiac abnormalities. By: Shayan Fatima Azad 3
- 4. By: Shayan Fatima Azad 4
- 5. ANATOMICAL TYPES Four main anatomical types based upon anatomical subsections of the interventricular septum. VSDType Name Synonym Occurance Description/Location Type 1 Peri membranous defect ConoventricularVSD 70-80% Most common Usually located within the membranous septum and may extend to tricuspid valve annulas or base of the aortic valve. Type 2 Muscular defect TrabecularVSD 10% Located within the membranous septum and often multiple. Type 3 Atrioventricular defect Atrioventricular canal type 5% Located in atrioventricular canal beneath the tricuspid valve. Type 4 Sub arterial defect Infundibular or sub arterialVSD 5-10% Lies with in the canal septum immediately subaortic. By: Shayan Fatima Azad 5
- 6. By: Shayan Fatima Azad 6
- 7. PATHOPHYSIOLOGY • A defect in the interventricular septum allows communication between the systemic and pulmonary circulations. • As a result, flow moves from a region of high pressure to a region of low pressure—that is, from the LV to the RV (a left-to-right shunt). • The pathophysiologic effects of aVSD derive from the hemodynamic effects secondary to a left-to-right shunt and from changes in the pulmonary vasculature. • A left-to-right shunt at the ventricular level has following hemodynamic consequences: 1. Increased LV volume load 2. Excessive pulmonary blood flow (may lead to progressive edema and congestive cardiac failure). 3. Reduced systemic cardiac output 4. Elevated pulmonary artery pressures (due to persistent elevated pulmonary blood flow and pulmonary vascular resistance lead to irreversible pulmonary hypertension) They may also result in reversal of flow across the defect called as Eisenmenger’s syndrome By: Shayan Fatima Azad 7
- 8. PATHOPHYSIOLOGY OF SHUNTING The pressure generated during contraction by the left ventricle is higher than that generated by the simultaneous contraction of the right ventricle. Blood will thus be pushed through the VSD (also called "shunted") from the left ventricle to the right ventricle. The right ventricle has to do extra work to handle the additional blood volume. It may have trouble keeping up with the load and enlarge, affecting its ability to pump efficiently. In addition, the lungs receive too much blood under too much pressure. The arterioles (small arteries) in the lungs thicken in response to the excess blood under excess pressure. If this extra pressure persists, permanent damage can be done to the lungs. It makes a considerable difference whether the size of the VSD is small or large By: Shayan Fatima Azad 8
- 9. CLINICAL PRESENTATION Depends upon: • The magnitude of the left-to-right shunt • Also depend upon size of shunt • Pulmonary and systemic resistance In first five years 30-50%VSD closes spontaneously Clinically: • A loud pan systolic murmur can be detected at left sternal border • Congestive cardiac failure (in first 2 months of life) • Pulmonary hypertension • Eisenmenger’s syndrome (in second decade of life) By: Shayan Fatima Azad 9
- 10. SIZES OF VSD By: Shayan Fatima Azad 10
- 11. RISK FACTORS Factors affecting the developing fetal heart can be associated with development ofVSDs. Genetic conditions (chromosomal, single gene or polygenic), like trisomy (Edward’s, Patau,Turner’s, Down’s syndrome) Environmental influences Fetal alcohol syndrome Gestational Diabetes Mellitus By: Shayan Fatima Azad 11
- 12. DIAGNOSIS ECG Chest X-Ray Echocardiography (degree of shunting) Cardiac catheterization (quantify various pressures between chambers and to assess the degree of pulmonary HTN and Oxygen saturation) By: Shayan Fatima Azad 12
- 13. WHAT TO DO?? Medical therapy Surgical closure (in case of failure of medical therapy) By: Shayan Fatima Azad 13
- 15. PROGNOSIS • Long term prognosis is excellent • If treated within 1-2 years of life By: Shayan Fatima Azad 15
- 16. HOPE YOU HAVE NO QUESTION By: Shayan Fatima Azad 16
- 17. By: Shayan Fatima Azad 17