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Encyclopedia > Ventricular septal defect
Ventricular septal defect
Classifications and external resources
Echocardiographic image of a moderate ventricular septal defect in the mid-muscular part of the septum. The trace in the lower left shows the flow during one complete cardiac cycle and the red mark the time in the cardiac cycle that the image was captured. Colours are used to represent the velocity of the blood. Flow is from the left ventricle (right on image) to the right ventricle (left on image).
ICD-10 Q21.0
ICD-9 745.4
DiseasesDB 13808
MeSH C14.240.400.560.540

A ventricular septal defect (or VSD) is a defect in the ventricular septum (the wall dividing the left and right ventricles of the heart). Image File history File links This is an ultrasound picture of the heart, an echocardiogram. ... It has been suggested that Transesophageal_echocardiogram be merged into this article or section. ... Cardiac cycle is the term used to describe the sequence of events that occur as a heart works to pump blood through the body. ... In the heart, a ventricle is a chamber which collects blood from an atrium (another heart chamber) and pumps it out of the heart. ... The right ventricle is one of four chambers (two atria and two ventricles) in the human heart. ... The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... // Q00-Q99 - Congenital malformations, deformations and chromosomal abnormalities (Q00-Q07) Congenital malformations of the nervous system (Q00) Anencephaly and similar malformations (Q01) Encephalocele (Q02) Microcephaly (Q03) Congenital hydrocephalus (Q04) Other congenital malformations of brain (Q05) Spina bifida (Q06) Other congenital malformations of spinal cord (Q07) Other congenital malformations of nervous... The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Diseases Database is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Interventricular septum: The stout wall separating the lower chambers (the ventricles) of the heart from one another. ... In the heart, a ventricle is a heart chamber which collects blood from an atrium (another heart chamber that is smaller than ventricle) and pumps it out of the heart. ... The heart and lungs, from an older edition of Grays Anatomy. ...


The ventricular septum consists of a muscular (inferior) and membranous portion (superior). The membranous portion (which is close to the atrioventricular node) is most commonly affected.[1][2] Look up membrane in Wiktionary, the free dictionary. ... The atrioventricular node (abbreviated AV node) is the tissue between the atria and the ventricles of the heart, which conducts the normal electrical impulse from the atria to the ventricles. ...


Congenital VSDs are collectively the most common congenital heart defect.[3] A congenital heart defect is a defect in the structure of the heart and great blood vessels of the newborn. ...

diagram of a healthy heart and one with VSD
diagram of a healthy heart and one with VSD

Contents

Image File history File links Ventricular_septal_defect. ... Image File history File links Ventricular_septal_defect. ...

Diagnosis

VSDs can be detected by cardiac auscultation, as they typically cause pan-systolic murmurs. Confirmation of findings from cardiac auscultation can be obtained with a cardiac ultrasound (echocardiography) (less invasive) and cardiac catheterization (more invasive). Auscultation is the technical term for listening to the internal sounds of the body, usually using a stethoscope. ... Front of thorax, showing surface relations of bones, lungs (purple), pleura (blue), and heart (red outline). ... Medical ultrasonography (sonography) is an ultrasound-based diagnostic imaging technique used to visualize muscles and internal organs, their size, structure and any pathological lesions, making them useful for scanning the organs. ... It has been suggested that Transesophageal_echocardiogram be merged into this article or section. ... Cardiac catheterization (heart cath) is the insertion of a catheter into a chamber or vessel of the heart. ...


Auscultation is generally considered sufficient for ruling-out a significant VSD, if done by a pediatric cardiologist.[4] This holds true as long as the pressures on the right side of the heart is low. Cardiology is the branch of medicine dealing with disorders of the heart and blood vessels. ...


Pathophysiology

The blood from the left ventricle flows across the defect into the right ventricle during ventricular contraction ( systole) and enters the pulmonary artery into the lungs where it returns to the left heart via the pulmonary veins into the left atrium and left ventricle. Hence there is volume loading of the left sided heart chambers in patients with significant defect. There is increased in the workload and congestion of the lung vessels in large defects. The pulmonary pressure is increased in large defects ( pulmonary hypertension) Most patients with large defect present with breathlessness, poor feeding and failure to thrive in infancy. Patients with small defects are asymptomatic.


Treatment

A nitinol device for closing muscular VSDs, 4 mm diameter in the centre. It is shown mounted on the catheter into which it will be withrawn during insertion.
A nitinol device for closing muscular VSDs, 4 mm diameter in the centre. It is shown mounted on the catheter into which it will be withrawn during insertion.

Treatment is either surgical (open or percutaneous endovascular) or conservative. Smaller congenital VSDs often close on their own (as the heart grows) and are thus treated conservatively. Open surgical procedures require a heart-lung machine and are done with a median sternotomy. Percutaneous endovascular procedures are less invasive and can be done on a beating heart, but are only suitable for certain patients. Repair of most VSDs is complicated by the fact that the conducting system of the heart is in the immediate vicinity. Image File history File linksMetadata Download high-resolution version (1582x589, 753 KB) A nitinol implantable device for closing a muscular VSD (Ventricular Septal Defect). ... Image File history File linksMetadata Download high-resolution version (1582x589, 753 KB) A nitinol implantable device for closing a muscular VSD (Ventricular Septal Defect). ... A heart-lung machine (upper right) in a coronary artery bypass surgery. ... Median sternotomy is a surgical procedure in which a vertical inline incision is made along the sternum, after which the sternum itself is divided, or cracked. This procedure provides access to the heart and lungs for surgical procedures such as heart transplant, corrective surgery for congenital heart defects (CHDs... In surgery, percutaneous pertains to any medical procedure where access to inner organs or other tissue is done via needle-puncture of the skin, rather than by using an open approach where inner organs or tissue are exposed (typically with the use of a scalpel). ... The EKG complex. ...


Epidemiology

VSDs are the most common congenital cardiac anomalies. They are found in 30% of all newborns with a congenital heart defect, or about 2-3 per 1000 births.


Congenital VSDs are frequently associated with other congenital conditions, such as Down syndrome.[5]


A VSD can form a few days after a myocardial infarction[6] (heart attack) due to mechanical tearing of the septal wall, before scar tissue forms, when macrophages start remodeling the dead (heart) tissue. A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, totally occluding the artery and preventing blood flow downstream. ... Look up septum in Wiktionary, the free dictionary. ... Scar Tissue is the Red Hot Chili Peppers first single from their album Californication. ... A macrophage of a mouse stretching its arms to engulf two particles, possibly pathogens Macrophages (Greek: big eaters, makros = long, phagein = eat) are white blood cells, more specifically phagocytes, acting in the nonspecific defense as well as the specific defense system of vertebrate animals. ...


See also

Atrial septal defects (ASD) are a group of congenital heart diseases that enables communication between atria of the heart and may involve the interatrial septum. ... Atrioventricular septal defect (AVSD) is characterized by a deficiency of the atrioventricular septum of the heart. ... Cardiac output is the volume of blood being pumped by the heart, in particular a ventricle in a minute. ... Cross-section of a healthy heart. ... Front of thorax, showing surface relations of bones, lungs (purple), pleura (blue), and heart (red outline). ... In medicine, pulmonary hypertension (PH) is an increase in blood pressure in the pulmonary artery or lung vasculature, leading to shortness of breath, dizziness, fainting, and other symptoms, all of which are exacerbated by exertion. ...

References

  1. ^ Ambumani P, Kuruchi Srinivasan. Ventricular Septal Defect, General Concepts. eMedicine.com. URL: http://www.emedicine.com/ped/topic2402.htm. Accessed on December 5, 2005.
  2. ^ Eidem BW. Ventricular Septal Defect, Muscular. eMedicine.com. URL: http://www.emedicine.com/ped/topic2543.htm. Accessed on April 13, 2006.
  3. ^ Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002 Jun 19;39(12):1890-900. PMID 12084585.
  4. ^ Geva T, Hegesh J, Frand M. Reappraisal of the approach to the child with heart murmurs: is echocardiography mandatory? Int J Cardiol. 1988 Apr;19(1):107-13. PMID 3372064.
  5. ^ Wells GL, Barker SE, Finley SC, Colvin EV, Finley WH. Congenital heart disease in infants with Down's syndrome. South Med J. 1994 Jul;87(7):724-7. PMID 8023205.
  6. ^ Bruckheimer E. Ventricular septal defect. Medical Encyclopedia - MedlinePlus.org, URL: http://www.nlm.nih.gov/medlineplus/ency/article/001099.htm. Accessed on December 5, 2005.

External links


  Results from FactBites:
 
VSD (375 words)
Ventricular septal defects are an abnormal communication at the ventricular level.
Operative closure of all ventricular septal defect is indicated by the second year of age, symptoms or not, as the risk for irreversible pulmonary vascular obstructive disease rises substantially thereafter.
Pulmonary artery banding is reserved for cases with multiple ventricular septal defect and in symptomatic patients with concomitant medical conditions such as RSV pneumonia or intracerebral hemorrhage.
New Page 1 (2850 words)
This kind of ventricular septal defect is very close to the tricuspid valve septal leaflets which may be damaged by shunting across the defect whether it is involved, or not in forming an aneurysmal pouch leading which may lead to ventricular septal defect closure.
Subaortic stenosis is usually a discrete membrane in the left ventricular outflow tract distal to the ventricular septal defect and rarely proximal to the defect.
In patients with ventricular septal defects or mitral stenosis the pulmonary arterial pressures may be elevated because of mitral stenosis and increased pulmonary blood flow, however, their effects are not additive, i.e.
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