- 🔬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.