Ventricular septal defect physical examination: Difference between revisions

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(New page: {{SI}} {{CMG}} and Leida Perez, M.D. '''Associate Editor-in-Chief:''' Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu] {{EH}} ==Physical Examination== '''Small...)
 
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'''Associate Editor-in-Chief:''' [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu]
{{CMG}}and Leida Perez, M.D.


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'''Associate Editor-In-Chief:''' [[User:KeriShafer|Keri Shafer, M.D.]] [mailto:kshafer@bidmc.harvard.edu], [[Priyamvada Singh]], [[MBBS]]


==Physical Examination==
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==Physical Examination <ref> Braunwald Zipes Libby.  Heart disease: A textbook of cardiovascular medicine, 6th Edition chapter 43:W.B. Saunders ;.pp 1533</ref> ==
'''Small VSD''':
'''Small VSD''':


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Revision as of 15:15, 8 July 2011

Ventricular septal defect Microchapters

Home

Patient Information

Overview

Classification

Pathophysiology

Causes

Differentiating Ventricular Septal Defect from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography

Cardiac Catheterization

Treatment

Medical Therapy

Surgery

Ventricular septal defect post-surgical prognosis

ACC/AHA Guidelines for Surgical and Catheter Intervention Follow-Up

Prevention

ACC/AHA Guidelines for Reproduction

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]and Leida Perez, M.D.

Associate Editor-In-Chief: Keri Shafer, M.D. [2], Priyamvada Singh, MBBS



Physical Examination [1]

Small VSD:

A systolic thrill may be palpable along the left sternal border and a loud holosystolic murmur (harsher quality than that of MR)localized to the left lower sternal border. In patients with small muscular defects, the murmur may end in mid systole because of systolic contraction of the septal musculature.

Medium-Sized VSD:

The rare patient who presents with a medium-sized defect or a moderate left-to-right shunt also may have a third heart sound (S3) and a short early middiastolic rumble due to increased left-sided volume overload.

Large-Sized VSD with Pulmonary Obstructive Disease:

In the first 2 years of age the patients have signs of left sided volume overload. After age 2 old, the patients have signs and symptoms of progressive pulmonary vascular obstructive disease. As a consequence, poor growth and left anterior thorax may bulge outward early. JVD may be elevated due to RV failure.

In the first two years there is a prominent LV impulse, but with the development of pulmonary hypertension, this LV prominence is diminished and cyanosis is present, worsens with effort and with time.

Example of VSD murmur: Media:VSD murmur.mp3

References

  1. Braunwald Zipes Libby. Heart disease: A textbook of cardiovascular medicine, 6th Edition chapter 43:W.B. Saunders ;.pp 1533

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