Congenital Heart Defects (acyanotic)

Ventricular septal defect

  • MC congenital heart defect that usually closes in childhood so LC seen in adults

  • Can also happen with MI


  • Can be alone or with other defects (TOF) and associated with Down syndrome, intrauterine infections (TORCH), fetal etOH

  • Pars membranacea (membranous septum) MC involved

  • Membranous region of septum grows down

  • Muscular ridge grows up ➔ x perforations instead of one hole


  • Harsh, holo(pan)systolic murmur at left lower sternal border

    • ↑ left side afterload ➔ ↑ intensity (handgrip)

  • Size of defect determines severity of sx

  • Smaller defects are louder


  • ECHO localizes defect, and determine shunting volume


  • Usually heals spontaneously so follow til 1yo

  • Surgical closure (patch repair): by 2yo if it doesn't close, severe HF sx, or developing pulmonary HTN

  • Heart and LUNG transplant once Eisenmenger syndrome develops