Doctor insights on:
Ventricular Septal Defect Murmur
Two ways: A large vsd with increased pulmonary blood flow may cause a diastolic flow rumble caused by a large amount of flow coming back from the lungs across the mitral valve into the left ventricle. Perimembranous and supracristal vsds can cause aortic valve deformation, and subsequent development of a diastolic murmur of aortic valve insufficiency. ...Read more
Not typical: The classic VSD physical finding is of course a holosystolic murmur. However, if the VSD is subarterial or supracristal, it can distort the aortic valve, sometimes causing leaflet prolapse. If this results in significant aortic insufficiency, there will be an associated diastolic murmur (with the insufficiency representing an indication for surgical repair). ...Read more
Holosystolic: Classically, a vsd results in increased blood flow from left to right ventricle due to pressure differences and results in a holosystolic murmur. Several situations where a diastolic murmur may be heard is 1) large vsd results in aortic cusp sucking into vsd and aortic regurg, 2) very large defect with so much flow to lungs and back to left side with diastolic rumble through mitral valve. ...Read moreSee 1 more doctor answer
Improved outcomes: Typically, if your child requires closure of his/her vsd, the proper therapy is open heart surgery. However, the outcomes of surgery are better than in the past, with safer anesthesia, improved cardiopulmonary bypass, better critical care, and less morbidity. It is not typical for catheter-based closure to be appropriate for vsds in children. ...Read moreSee 1 more doctor answer
Rarely: A large vsd that is untreated can lead to the development of pulmonary hypertension during childhood. It worsens over time and ultimately results in shunting of blood from the right ventricle through the vsd into the aorta and causing cyanosis (blue skin). ...Read moreSee 1 more doctor answer
Can one have valve regurgitation, atrial septal defects, or ventricular septal defects but still have normal and murmurless heart sounds?
I have read that only 3 things cause a holosystolic murmur. Tricuspid regurg, mitral regurg, and ventricular septal defect. Are these the only 3?
Essentially: Technically an lv to RA shunt would also generate a holosystolic murmur. In some ways this could be considered a combination of a vsd and tr, although there is actually a distinct entity involving the atrioventricular septum. (also, from a practical standpoint, it can sometimes be difficult to distinguish a long systolic ejection murmur from a holosystolic murmur.). ...Read moreSee 1 more doctor answer
Several tests. : There are several tests: physical exam, cxr, ekg, echocardiogram and catheterization. Really the best test is an echocardiogram (with a good physical exam); this should give all the necessary information about the vsd and help guide treatment. Vsds tend to close on their own over time but if they don't and cause symptoms, an operation may be required (usually with excellent outcomes). ...Read moreSee 1 more doctor answer
Depends on size: Many vsds are mild and close on their own. Some are quite big and need surgery to repair them. Symptoms can be nothing to fatigue from shunting blood the wrong way. There is usually a loud heart murmur but that does not cause symptoms alone. A cardiologist can provide more information for the specific patient. ...Read moreSee 1 more doctor answer
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