How big can a "small" vsd be?

Tiny. As a matter of fact a smaller hole can be the loudest. And can be "hemodynamically" insignificant.
Term relative. When i hear the high pitched noise of a small vsd, i take great comfort in the finding. I know from experience it may close on it's own in a few months & is unlikely to lead to heart failure in the infant. I tell parents "i hear s small vsd" & order a test to confirm my impression(usually a few mm's).When the defect is big, no murmur may be generated & big trouble is likely.
Term relative. When i hear the high pitched noise of a small vsd, i take great comfort in the finding. I know from experience it may close on it's own in a few months & is unlikely to lead to heart failure in the infant. I tell parents "i hear s small vsd" & order a test to confirm my impression(usually a few mm's).When the defect is big, no murmur may be generated & big trouble is likely.
Term relative. When i hear the high pitched noise of a small vsd, i take great comfort in the finding. I know from experience it may close on it's own in a few months & is unlikely to lead to heart failure in the infant. I tell parents "i hear s small vsd" & order a test to confirm my impression(usually a few mm's).When the defect is big, no murmur may be generated & big trouble is likely.