Ventricular septal defects (VSD) are the most common cause of congenital heart disease. They close spontaneously in around 50% of cases.

Aetiology

• congenital VSDs are often association with chromosomal disorders
  • Down's syndrome
  • Edward's syndrome
  • Patau syndrome
  • cri-du-chat syndrome
• congenital infections
• acquired causes
  • post-myocardial infarction

Clinical features

VSDs may be detected in utero during the routine 20 week scan. Post-natal presentations include:

• failure to thrive
• features of heart failure
  • hepatomegaly
  • tachypnoea
  • tachycardia
  • pallor
• classically a pan-systolic murmur which is louder in smaller defects

Investigations

• CXR - may show cardiomegaly
• Echocardiogram - visualisation of VSD

Management

is clearly highly specialised

• small VSDs which are asymptomatic often close spontaneously are simply require monitoring