Symptoma

Acquired Ventricular Septal Defect

Traumatic VSD is variable in its presentation, severity and clinical course. We present the case of rupture of the ventricular septum in 7-year-old boy following blunt chest trauma. [njcponline.com]

Healed myocardial infarcts were present in 3 patients. All 16 patients had severe (greater than 75% in cross-sectional area) narrowing of 1 or more of the 4 major epicardial coronary arteries. [ncbi.nlm.nih.gov]

We conclude that a diagnosis of traumatic VSD, though rare, should be considered in any previously well child presenting in acute congestive cardiac failure following blunt trauma to the chest. [ajol.info]

The clinical presentation varied from asymptomatic to progressive heart failure. The timing of the diagnosis also varied significantly from immediately post valve implantation up to 1 year. [heartvalvesociety.org]

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  • Camping

    § Assistant chief of medicine, United States Naval Hospital, Camp LeJeune, North Carolina. [nejm.org]

  • Heart Disease

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  • Systolic Murmur

    Small to moderate resistive systolic murmurs may be louder than large non-resistive systolic murmurs. Clinical Signs Clinical signs of VSDs may include signs of left-sided heart failure. [lsu.edu]

    The blood pressure was 100/65 mm Hg and there was a harsh systolic murmur at the left sternal edge. The chest was clear and there was no peripheral oedema. Neurological examination revealed an ataxic gait with right upper limb weakness grade 4/5. [pmj.bmj.com]

    Although initially no murmur was heard, within 24 hours of admission a Grade 2/6 pan systolic murmur was detected at the left lower sternal border and subsequently increased in intensity to Grade 3/6. [njcponline.com]

    A grade 2 to 5/6 systolic murmur is audible at the lower left sternal border. It may be pansystolic or early systolic. [patient.info]

    On the second day, a systolic murmur was detected and Doppler echocardiography revealed an apical muscular VSD (Figure 1A), which motivated transfer to our center. [revespcardiol.org]

  • Heart Murmur

    The blood flowing through the hole creates an extra noise, which is known as a heart murmur. The heart murmur can be heard when a doctor listens to the heart with a stethoscope. [kidshealth.org]

    However the heart murmur was no longer audible on auscultation and no VSD could be demonstrated on echocardiography (fig 2). [pmj.bmj.com]

    The only sign may be a heart murmur – or whooshing sound – that the physician may hear via a stethoscope. If the hole is large, side effects may be noted in newborns or may not appear until months later. [childrens.memorialhermann.org]

    The physician will listen to the heart with a stethoscope (auscultation) to detect a heart murmur. X rays, electrocardiogram (ECG), and echocardiography can all be used to evaluate ventricular septal defect. [medical-dictionary.thefreedictionary.com]

    Progressive dyspnea, worsening congestive heart failure, and pansystolic heart murmur found during physical examination were the usual initial presentations. [the-medical-dictionary.com]

  • Fracture

    The CXR showed bilateral patchy opacities but no fractures. [njcponline.com]

    Due to the high rate of residual shunt and larger delivery system, the device was modified initially to the Clamshell device and later due to high rate of frame fracture, it was modified to the Cardioseal and and the Starflex devices. [fac.org.ar]

  • Irritability

    Children with large defects may show rapid breathing, poor weight gain, restlessness, and irritability. Diagnosis is established by echocardiography and cardiac catheterization. [medical-dictionary.thefreedictionary.com]

    Pericardial effusion: this is a very rare complication that may result from catheter irritation or minute wire perforation during the procedure. TTE after 24 hr is essential prior to the discharge of the patient from the hospital. [heartviews.org]

  • Aura

    There was no precipitating chest pain or aura. He had undergone cystoscopy and biopsy for dysuria three weeks before admission. He was a smoker of 40 packet years with no pre-existing cardiovascular symptoms or history. [pmj.bmj.com]

  • Limb Weakness

    Neurological examination revealed an ataxic gait with right upper limb weakness grade 4/5. The lower limbs were normal and the plantar reflexes equivocal. [pmj.bmj.com]

  • Confusion

    Classification and nomenclature of VSDs can be confusing to the nonpediatric practitioner. For simplicity, this chapter will refer to them by their most commonly used names. Figure 17–1 depicts the types of VSDs based on their location. [thoracickey.com]

  • Dysuria

    He had undergone cystoscopy and biopsy for dysuria three weeks before admission. He was a smoker of 40 packet years with no pre-existing cardiovascular symptoms or history. He denied a history of hypertension and his lipid profile was normal. [pmj.bmj.com]

Diagnostic Workup for Pediatric Ventricular Septal Defect Patients with significant pulmonary hypertension and a right-to-left shunt might develop polycythemia due to hypoxemia. [lecturio.com]

  • Cardiomegaly on Chest X-ray

    Such indications include: clinical evidence of significant left-to-right shunt with congestive heart failure, poor weight gain, cardiomegaly on chest X ray and or dilated left sided cardiac chambers on echocardiography. [heartviews.org]

  • Right Axis Deviation

    Restrictive VSDs usually produce a normal tracing, a wide notched P wave due to left atrial overload is the characteristic of Medium-sized VSDs produce, and large VSDs shows hypertrophy of the right ventricle with right-axis deviation. [ukessays.com]

    In those with pulmonary hypertension, right axis deviation, right ventricular hypertrophy (RVH) and right atrial hypertrophy (RAH) may be seen. CXR CXR is normal in patients with small VSDs. [patient.info]

  • Left Axis Deviation

    Investigations The electrocardiogram showed sinus rhythm 100 beats/min, left axis deviation, ST elevation, and T wave inversion in the anteroseptal leads. The chest radiograph was normal. [pmj.bmj.com]

  • T Wave Inversion

    Investigations The electrocardiogram showed sinus rhythm 100 beats/min, left axis deviation, ST elevation, and T wave inversion in the anteroseptal leads. The chest radiograph was normal. [pmj.bmj.com]

  • Biventricular Hypertrophy

    With further progression of the defect, the ECG shows biventricular hypertrophy; P waves may be notched or peaked. [ukessays.com]

    With large VSDs the ECG shows biventricular hypertrophy (BVH) with or without LAH. In those with pulmonary hypertension, right axis deviation, right ventricular hypertrophy (RVH) and right atrial hypertrophy (RAH) may be seen. [patient.info]

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He was diagnosed with extensive anterior myocardial infarction and therefore did not receive fibrinolytic treatment. [revespcardiol.org]

Treatment Options Medical Management: Small sized VSDs are often asymptomatic and need no medical treatment, but monitoring. [ukessays.com]

Treatment Although small resistive VSDs often have loud murmurs, the consequences of this defect are small and this defect does not require treatment. [lsu.edu]

The long-term prognosis with medical therapy is extremely poor. We report on a patient who developed progressive heart failure within 3 months after myocardial infarction due to an unknown VSD. The left ventricular function was severely impaired. [ncbi.nlm.nih.gov]

The diagnosis of this situation is of importance because of the poor prognosis which it carries. 1989 S. [karger.com]

Septal rupture associated with anterior infarction tends to be apical and have a better prognosis than rupture complicating inferior infarction which affects the basal septum. 5 Spontaneous closure of congenital atrial and VSDs is well recognised, but [pmj.bmj.com]

Prognosis The prognosis for a patient with an isolated VSD is excellent. Most small-to-moderate muscular VSDs can be expected to close spontaneously. [patient.info]

Complications of acute myocardial infarction that develop within the first 2 weeks after its onset have been associated with a poor prognosis. [cardiothoracicsurgery.biomedcentral.com]

High clinical suspicion is needed when patient is deteriorating and no other obvious etiology is identified as the condition is often treatable with percutaneous approach. Back to 2016 Annual Meeting Posters [heartvalvesociety.org]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

complication of MI Some reports of iatrogenic causes Genetics Multifactorial etiology; autosomal dominant and recessive transmissions have been reported. [unboundmedicine.com]

Despite the identification of these risk factors for VSDs, most cases remain of unknown etiology. [lecturio.com]

The precise etiology for the disruption of normal ventricular septation is not known, although both genetic and environmental factors have been implicated in the development of ventricular septal defects. [clinicaladvisor.com]

Can be tolerated during pregnancy if VSD is small May be associated with an increased risk of preeclampsia in women with an unrepaired VSD Epidemiology Incidence Congenital defect: no gender predilection, occurs in 2/1,000 live births and accounts for [unboundmedicine.com]

Acquired VSD can occur as a result of a septal myocardial infarct but such a finding is much rarer than congenital lesions and prognosis tends to be poor. [ 2 ] Epidemiology [ 3 ] VSDs are the most common congenital heart defect in children, occurring [patient.info]

[…] with potential placement of a local anesthetic infusion catheter under the fascia, to enhance postoperative pain control. j) Multiple muscular VSDs are a challenge to close, achieving a complete closure can be aided by the use of fluorescein dye. [15] Epidemiology [en.wikipedia.org]

Epidemiology of Pediatric Ventricular Septal Defect Ventricular septal defects are considered the second most common type of congenital heart disease preceded by bicuspid aortic valve anomaly. [lecturio.com]

Factors Affecting the Pathophysiology of VSD The subsequent natural history and pathophysiology depends on The size of the defect The magnitude of left-to-right shunting. [wikidoc.org]

Pathophysiology Significant left to right shunting can occur resulting in a high left ventricular cardiac output. Forward systemic flow can be reduced if the shunt is large resulting in symptoms of congestive heart failure. [healio.com]

Prevalence In the United States: Occurs in 50% of all children with congenital heart disease Low prevalence in adults ( 0.3 per 1,000) due to spontaneous closure Post-MI complication in 0.2–3% of cases Etiology and Pathophysiology Congenital In adults [unboundmedicine.com]

VSD appears either as an isolated cardiac defect or with several complex malformations such as pulmonary hypertension, pulmonary stenosis or aortic regurgitation- which all play a role in the pathophysiologic consequence of the disease. [ukessays.com]

Expansion of transmural myocardial infarction: a pathophysiological factor in cardiac rapture. Circulation 1979; 60:1532-1538 (21) Bedynek J, Fenoglio J, McAllister H. [the-medical-dictionary.com]

Medicines may be used temporarily to help with symptoms, but they don't cure the VSD or prevent permanent damage to the lung arteries. [heart.org]

Cardiac Exercise Stress Testing Read More Hawaii Public Radio’s The Body Show: Atrial Fibrillation Read More Ask a Specialist on KHON2: Heart Failure Read More Ask a Specialist on KHON2: Women and Heart Disease Read More Queen's Speaking of Health - Prevention [qhpp.com]

Once the device is released, the cable and the pusher catheter should be brought inside the sheath immediately to prevent any injury from the sharp end of the cable. [heartviews.org]

Risk Factors Congenital VSD: Risk of sibling being affected: 4.2% Risk of offspring being affected: 4% Prematurity Post-MI VSD: Advanced age Arterial HTN First MI Most frequent within 1st week after MI Most commonly after anterior wall acute MI General Prevention [unboundmedicine.com]