1.Pathophysiology of ventricular defect
(hypertrophy) (high pressure) (congestion)
Upper and lower vena cava → right atrium → right ventricle → pulmonary artery ↑ → pulmonary circulation ↑
(enlargement) (hypertrophy)
→ pulmonary vein → left atrium ↑ → left ventricle ↑ → aorta ↓ → body circulation ↓
2.Symptoms of ventricular deficiency
symptoms of congestion in the pulmonary circulation: panic, shortness of breath, cough, lung infection, heart failure, pulmonary edema
symptoms of ischemia in the body circulation: stunted growth, wasting, weakness.
Others: pulmonary A compression of the recurrent laryngeal nerve causing hoarseness, cyanosis when pulmonary A hypertension is severe.
3.Signs of ventricular ischemia
(1) Look: when the heart is enlarged, the precordial region is elevated and the apical pulsation is diffuse.
(2) Palpation: systolic tremor can be palpated between L3 and 4 ribs.
(3) Percussion: enlargement of the cardiac border.
(4) Hearing: III-IV rough and loud SM can be heard in L3 and 4, and P2 is hyperactive. When pulmonary A hypertension is obvious, the heart murmur is reduced, while P2 is significantly hyperactive.
4.Examination of ventricular defect
(1) X-ray: no obvious changes in small defects. (2) X-ray: in small defects, there are no obvious changes. In larger defects, X-ray shows enlarged left and right ventricles, prominent pulmonary A segment, congested lung fields, chorea of the pulmonary hilum, and small main A arch.
(2) EKG: normal or showing mild left ventricular hypertrophy in small defects and left and right ventricular hypertrophy in large defects.
(3) Echocardiography: in addition to left and right ventricular enlargement, the site and size of the defect can be directly detected, and Doppler flow imaging can detect the direction and size of the shunt.
(4) Cardiac catheterization: the oxygen content of the right ventricle is higher than that of the right atrium, and the pressure of the right ventricle and lung A is ↑.
5.Treatment of ventricular defect
Membranous and myocardial VSDs have the possibility of natural closure and usually occur within 5 years of age.
Moderate defects require surgical repair.