Ventricular septal defect (VSD) is a congenital heart defect where there is a hole in the wall separating the two lower chambers of the heart (ventricles). VSDs can range from small to large. Small VSDs often close on their own while large VSDs require medical or surgical treatment. VSDs are diagnosed using tests like echocardiograms, electrocardiograms, and chest x-rays. Treatment may involve medications to manage symptoms or surgery to repair the hole in the ventricle wall. Post-surgery, patients need monitoring and antibiotics to prevent infection.

1. Ventricular Septal
defect (VSD)
Miljie
Tompong

2. Ventricular septal defect (VSD)?
• a heart malformation
present at birth.
"congenital" condition
• a type of congenital
heart disease (CHD).

3. Anatomy and physiology
• The heart with a VSD has a hole in the wall (the septum) between its two lower
chambers (the ventricles).

5. How do VSDs cause problems?

6. How is a VSD diagnosed?
• chest X-ray

7. • Echocardiogram
(used to define
the anatomy
and evaluate
the
characteristics
(amount and
pressures) of
the shunted
blood)

8. Electrocardiogram
• is a noninvasive
test that is used
to reflect
underlying
heart
conditions by
measuring the
electrical
activity of the
heart.

9. What are the symptoms of a VSD?
• A murmur is a sound
generated by abnormally
turbulent flow of blood
through the heart.
• symptomless at birth
usually develop until later
in the first week of life.
• no signs of cyanosis.

10. • Small defects (less than
0.5 square cm) are
common
• small VSDs close
spontaneously (on their
own).
• closure is due to the
small VSD being located
between heart fibers that
increase in size in time

11. • large VSD (usually one
greater than 1 cm2
• Infant will fail to thrive
and become sweaty
and tachypnoiec
(breathe faster) with
feeds
• increase in the blood
pressure of the lungs
called "pulmonary
hypertension.

12. Medical Management
• Digoxin (LANOXIN)
• works directly on the heart to increase the
velocity of contraction and the force of the
contraction.
• FUROSEMIDE (LASIX)
• Diuretics remove edema and act to lower
blood pressure. This helps reduce the extra
load on the pulmonary system.

13. Treatment
• PA Banding
a palliative
treatment
particularly
reserved for those
patients who are
unable to
withstand an open
heart procedure
for total
correction.

14. Surgical Treatment
• median sternotomy
• Surgical access to the VSD depends upon it's
location and the presence of other cardiac
defects.
• The right ventricle is often opened to gain
access to perimembranous or inlet defects.
• The pulmonary artery may be used to close
outlet septum VSDs

15. • Large defects
may be repaired
using a
pericardium
patch sutured
into place to
occlude the
space.

16. Preoperative and postoperative
• prophylactic antibiotics are often required to
prevent infectious endocarditis.
• The child should be assessed postoperatively
for dysrhythmia, since edema in the septum
may interfere with conduction.

17. Nursing Diagnosis
“Decrease in cardiac output
associated with heart
malformations”
Objective: improve the heart Rainfall
Outcome criteria: signs of improvement in cardiac
output

18. Nursing Intervention :
• Observation of the quality and strength of heart
rate, peripheral pulse, skin color and warmth.
• Set the degree of cyanosis (mucous membranes,
clubbing)
• Monitor signs of CHF (anxiety, tachycardia,
tachipnea, cramped, tired while drinking milk,
periorbital edema, and hepatomegaly Oliguria.
• Collaboration for the administration of drugs
(diuretics, to reduce after load) as indicated.