Ventricular Septal Defect (VSD)
Cardiovascular · ~11% of blueprint- Pathophysiology
- Most common congenital heart defect after aortic valve defects. Opening in the interventricular septum → left-to-right shunt (acyanotic). Large defects → pulmonary overcirculation; if untreated may progress to Eisenmenger (high PVR, bidirectional shunting → cyanosis).
- Signs & Symptoms
- Harsh holosystolic murmur at the left lower sternal border (smaller defect = louder murmur). Large: failure to thrive, tachypnea, recurrent respiratory infections, HF signs.
- Gold Standard Diagnosis
- Echocardiography (location, size, shunt direction).
- First-line Treatment
- Small defects often close spontaneously → observe. Large/symptomatic → surgical or transcatheter closure; diuretics for HF symptoms as a bridge.
Drug cardsFurosemide
High-Yield Pearl
Most common congenital heart defect after aortic valve defects; smaller VSD = louder murmur. Untreated large shunt → Eisenmenger syndrome (high PVR, bidirectional shunting, chronic cyanosis).
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Sources
Reviewed September 2026- 2025 ACC/AHA/HRS/ISACHD/SCAI Guideline for the Management of Adults With Congenital Heart Disease — ACC/AHA/HRS/ISACHD/SCAI, 2025
- StatPearls: Ventricular Septal Defect — NCBI Bookshelf / StatPearls, 2025
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