VSD

Question 1

Small VSD murmur

Answer 1

Loud pan systolic murmur at the lower left sternal edge Radiates to whole precordium

Question 2

Management of small VSD

Answer 2

Lesion will close spontaneously

Maintain good oral hygiene to prevent bacterial endocarditis whilst defect is present

Question 3

How big is a large VSD

Answer 3

small size or bigger than the aortic valve

Question 4

Large VSD mumur

Answer 4

Soft pan systolic murmur or no murmur

Question 5

Clinical features of large VSD

Answer 5

1. Heart failure with breathlessness - Increased pulmonary oedema, vascular markings + Pulmonary hypertension
2. Failure to thrive
3. Recurrent chest infections

Question 6

Ix of VSD

Answer 6

1. Chest radiograph;
   - Cardiomegaly - Enlarged pulmonary arteries and markings
2. ECG - Biventricular hypertrophy

Question 7

Management of VSD

Answer 7

1. Medication - Diuretics/Captopril

2. Pulmonary artery band - to reduce pulmonary hypertension