Ventricular septal defect physical examination

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Ventricular septal defect Microchapters


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Differentiating Ventricular Septal Defect from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis


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Ventricular septal defect post-surgical prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Priyamvada Singh, MBBS; Keri Shafer, M.D. [2]; Leida Perez, M.D.


The physical examination findings of a ventricular septal defect depend upon the size of the defect, the location of the defect, the magnitude and directionality of the intracardiac shunt, and the age of the patient (the duration of the VSD).

Physical Examination



Small VSD
Medium-Sized VSD
Large-Sized VSD with Pulmonary Obstructive Disease
  • The features are similar to those seen in a medium-sized VSD.
  • In the first 2 years of life, the patient may have signs of left sided volume overload. After the age of 2 years, the patient have exhibit signs and symptoms of progressive pulmonary vascular obstructive disease (pulmonary hypertension). As a consequence, poor growth may be present and the left anterior thorax may bulge outward.
  • The JVP may be elevated due to right ventricular failure.
  • In the first two years of life there may be a prominent LV impulse or heave, but with the development of pulmonary hypertension, this LV prominence is diminished and cyanosis may be present which worsens with effort and with time.


Small VSD
Moderate VSD
Large VSD

A large VSD may progress to Eisenmenger's syndrome. Physical examination may reveal the following:

Video Examples of Physical Examination Findings

In first video one can appreciate the normal heart sound. On careful listening one can appreciate the S1 and S2 (lub-dub): {{#ev:youtube|xS3jX1FYG-M}}

In the second video one can appreciate that the first and second heart sounds are not audible and a murmur that covers the whole systole is there. This is characteristic holosystolic murmur of ventricular septal defect: {{#ev:youtube|7oKz6J0Ay_I}}


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