most common CHD(30-50%)
small VSD (majority)
clinical presentation:
history: aSx, normal growth, and development
Px: early systolic to holosystolic murmur, best heard at LLSB, thrill
investigations: ECG and CXR are normal
management: most close spontaneously
moderate-to-large VSD
epidemiology: CHF by 2 mo; late secondary pulmonary hypertension if left untreated
clinical presentation
Hx: delayed growth, decreased exercise tolerance, recurrent URTIs or “asthma” episodes
Px: holosystolic murmur at LLSB, mid-diastolic rumble at apex, size of VSD is inversely related to intensity of murmur
investigations:
ECG: le ventricular hypertrophy (LVH), le atrial hypertrophy (LAH), RVH
CXR: increased pulmonary vasculature, cardiomegaly, CHF
management: treatment of CHF and surgical closure by 1 yr old