Classifications

• Recall Heart Embryology → Membranous septum has 3 contributing parts

  

1. Perimembranous VSD → Any of the 3
2. Muscular VSD → muscular septum
3. Inlet VSD → AV endocardial cushion
   1. associated with AVSD, down syndrome
4. Outlet VSD → conotruncal swelling

• Malalignment VSD → ToF

Relevant Physiology

Pathogenesis

• L → R shunt
• Increased Pulmonary Blood Flow (PBF)
• LA, LV dilation (Blood shunted during systole → directly enter pulmonary circulation → return to left side)

Prognosis/Disease Course/Complications

• Pulmonary hypertension
• Congestive Heart Failure (CHF) in 1-2 month (after pulmonary resistance gradually decreased)
• Eisenmenger Syndrome over time

Presentation

Signs and Symptoms

Precordial exam: Murmur