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Ventricular septal defect is a cardiac anomaly where there are openings between the left and right ventricles through the septum. It can occur in different locations of the septum and be associated with other cardiac defects. Symptoms depend on the size of the opening and amount of blood shunting between the ventricles. Imaging such as echocardiogram, CT, and MRI are used to diagnose and characterize the location and size of the defect.

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Melinda Kanani
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33 views

First Page PDF

Ventricular septal defect is a cardiac anomaly where there are openings between the left and right ventricles through the septum. It can occur in different locations of the septum and be associated with other cardiac defects. Symptoms depend on the size of the opening and amount of blood shunting between the ventricles. Imaging such as echocardiogram, CT, and MRI are used to diagnose and characterize the location and size of the defect.

Uploaded by

Melinda Kanani
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Ventricular Septal Defect

KEY FACTS
Cardiac

TERMINOLOGY ○ Multiple muscular VSDs: "Swiss cheese" septum


• Cardiac anomaly with communication(s) between left & ○ Shunt volume estimated by velocity encoded cine MR
right ventricles through septum imaging
○ Perimembranous septal defect (80%) TOP DIFFERENTIAL DIAGNOSES
○ Posterior or inlet defect associated with atrioventricular • Atrioventricular canal defects
septal defect (AVSD) (8-10%)
• Patent ductus arteriosus
○ Muscular or trabecular septal defect (5-10%)
• Double outlet right ventricle
○ Outlet septal defect or supracristal ventricular septal
defect (VSD) (5%) CLINICAL ISSUES
• Complex cardiac anomalies with VSD: TOF, truncus, DORV • Small VSD: Children asymptomatic but have heart murmur
IMAGING ○ May close spontaneously
• Moderate or large shunts often asymptomatic early until
• Cardiomegaly with ↑ size of main pulmonary artery, ↑
pulmonary vascular resistance drops
pulmonary artery flow, left atrial enlargement, & usually
○ Children develop tachypnea, tachycardia, diaphoresis, &
small aorta
failure to thrive
• Hyperinflation in large shunts from abnormal lung
○ Treated medically with subsequent surgical approach
compliance & bronchial compression by dilated pulmonary
arteries – Muscular lesions require more difficult surgical
approach; VSD catheter closure devices often used
• CT & MR delineate anatomy

(Left) Axial SSFSE T2 fetal MR


shows a perimembranous-type
ventricular septal defect (VSD)
ſt in this fetus with tetralogy
of Fallot. (Right) Three-
chamber view from a cine
sequence cardiac MR shows an
aneurysm ﬉ of the
membranous ventricular
septum protruding into the
right ventricle. This likely
represents the spontaneous
membranous closure of a
previously patent VSD. When
large, the aneurysm may cause
right ventricular outflow tract
obstruction.

(Left) Frontal radiograph of


the chest shows cardiomegaly
with increased pulmonary
vascularity in a patient with
multiple intramuscular-type
VSDs. Multiple VSD closure
devices ﬉ have been placed in
an attempt to decrease
shunting. (Right) Oblique axial
cardiac CTA shows a Swiss
cheese appearance of the
interventricular septum st
near the apex in this patient
with multiple muscular-type
VSDs. Notice the normal
positions of the septum ﬈.

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