Ventricular Septal Defect

Question 1

Ventricular Septal Defect is what type of congenital heart defect?

Answer 1

Increased Pulmonary Flow

Question 2

Pathophysiology of Ventricular Septal Defect

Answer 2

1. An opening between the right and left ventricle chambers of the heart
2. A left to right shunt results when pulmonary vascular resistance is low
3. Increased amounts of blood flowing into the right ventricle are then pumped to the pulmonary circulation causing an increased in pulmonary vascular resistance
4. Increased pulmonary resistance leads to increased pulmonary artery pressure (pulmonary hypertension) and right ventricular hypertrophy

Question 3

Signs and Symptoms

Answer 3

• Tachypnea and Tachycardia
• Poor weight gain
• Fluid Retention (causing edema)
• Tiring easily
• Shortness of Breath
• Holosystolic harsh murmur (blood shunting the wrong way) (heard best at left sternal boarder)
• Decreased peripheral perfusion
• Weak pulses
• Infant becomes diaphoretic
• Increased work of breathing

Question 4

Nursing Assessment: Health History

Answer 4

1. Signs of heart failure around 4-8 weeks of age
2. Note signs of tiring easily (with exertion or feeding)
3. Note difficulty thriving
4. Ask about color change or diaphoresis with nipple feedings in the infant
5. Note frequent pulmonary infections, SOB and possible edema
6. Note mild tachypnea

Question 5

Nursing Assessment: Physical Examination

Answer 5

1. Auscultate the heart (HOLOSYSTOLIC HARSH MURMUR along left sternal boarder)
2. Adventitious breath sounds is the child is experiencing heart failure
3. Palpate chest for a thrill

Question 6

Nursing Assessment: Diagnostics

Answer 6

1. MRI
2. Electrocardiogram
3. Cardiac Catheterization

Question 7

Potential Complications

Answer 7

• Pulmonary Infections
• Pulmonary Hypertension
• Right ventricular hypertrophy
• Aortic Valve Regurgitation
• Infective Endocarditis
• Edema (infants and children: face, presacral)
  (Older children: extremities)
• Heart Failure