Knowledge Check: Ventricular Septal Defects
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Question 1 of 5
1. Question
Which of the following is TRUE about muscular VSDs?
Hint
Muscular VSDs are the most common (60%) and often present with multiple defects. Up to 1/3 of these will close spontaneously.
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Question 2 of 5
2. Question
A 1-year-old boy with Trisomy 21 has a pansystolic murmur on cardiac auscultation during a well child exam. Which of the following cardiac defects is MOST commonly associated with his underlying condition?
Hint
Trisomy 21 is commonly associated with atrioventricular canal defects.
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Question 3 of 5
3. Question
Which of the following best describes the physiology of VSDs?
Hint
VSD’s shunt during systole. Because the right ventricle is undergoing contraction at the same time as the left ventricle, most of the blood is shunted towards the pulmonary vasculature before returning to the left side of the heart.
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Question 4 of 5
4. Question
Which of the following represents the MOST likely presentation of a large VSD?
Hint
Children with physiologically significant VSDs often present with symptoms of congestive heart failure, that result from increased pulmonary blood flow and increased cardiac output due to left-to-right shunting at the ventricular level, leading to an increase in metabolic demand.
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Question 5 of 5
5. Question
You are seeing a 9-month old child with a muscular VSD for a routine well child visit. The child is growing along the 25th percentile for weight and 50Th percentile for height. The parents report the child doesn’t have any increased work of breathing. The child’s medications include daily dosing of furosemide. Clinical exam, chest radiograph, ECG, and echocardiogram have stable findings from last visit 3 months ago. What is the next best step in management of this child’s VSD?
Hint
Infants without overt signs of failure to thrive or pulmonary hypertension can await definitive surgical repair, as muscular defects may close spontaneously over time.
