From the Guidelines
Ventricular Septal Defect (VSD) typically presents with a holosystolic murmur.
Auscultation Findings
- A holosystolic murmur is audible at the lower left sternal border, similar to those patients with normal connections 1.
- The murmur is due to the left-to-right shunt through the VSD.
Clinical Presentation
- The clinical presentation of VSD depends largely on defect size and pulmonary vascular resistance (PVR) 1.
- Small defects (<25% of the aortic annulus diameter) may present with a systolic murmur and no left ventricle volume overload.
- Moderate-sized defects (25-75% of the aortic diameter) may present with a systolic murmur and mild to moderate left ventricle volume overload.
Diagnostic Considerations
- A VSD jet may be mistaken for a tricuspid regurgitation (TR) jet in a patient with normal pulmonary pressure 1.
- Patients with a small VSD and aortic valve prolapse may develop progressive aortic regurgitation (AR).
Natural History
- Patients with a closed VSD or a small residual VSD usually remain asymptomatic and do not require surgery 1.
- However, an unknown percentage of patients with a small residual VSD may develop problems later in life, such as endocarditis, left ventricle volume overload, or arrhythmias.
From the Research
Auscultation Findings in Ventricular Septal Defect (VSD)
The expected auscultation findings in a patient with Ventricular Septal Defect (VSD) are not explicitly described in the provided studies. However, the studies discuss the diagnosis and management of VSDs, which may imply the following:
- A VSD is typically characterized by a murmur, but the specific characteristics of the murmur are not described in the studies 2, 3, 4, 5, 6.
- The studies focus on the use of echocardiography and other diagnostic tools to characterize and manage VSDs, rather than auscultation findings 3, 4, 5, 6.
- One study mentions the use of digital recordings of heart sounds and phonocardiograms to detect heart murmurs in patients with VSDs, but does not describe the specific auscultation findings 2.
Diagnostic Approaches
The studies discuss the following diagnostic approaches for VSDs:
- Echocardiography is a crucial tool for diagnosing and characterizing VSDs 3, 4, 5, 6.
- Careful history-taking, physical examination, chest X-rays, and electrocardiograms provide basic information, but echo-Doppler studies are essential for assessing the defect's clinical significance 4.
- Advanced optical coherence tomography network-processed phonocardiogram may be a useful diagnostic tool for detecting VSDs, but its performance is not superior to cardiologist assessment 2.