VSD: Assessment & Diagnosis
Ventricular septal defect is often not
diagnosed before 4 to 8 weeks of age. Prior to this age the
lung's alveoli are not completely opened. As a result, there is
high pulmonary artery resistance. This resistance limits the
amount blood shunted through the defect.
As lungs develop, pulmonary circulation
expands and pulmonary resistance decreases. When pulmonary resistance falls
below the pressure generated by the left ventricle, blood will flow across
the vsd toward the area of lower pressure.
If a child shows signs of congestive heart
failure, further assessments are made. Findings that suggest VSD
- At about 4 to 8 weeks of age, a loud,
harsh, systolic murmur may be heard along the left
sternal border at the 3rd or 4th interspace. The murmur
is widely transmitted and a thrill may be palpated.
- The additional shunted blood to the right
side, and extra work the right side has to perform to
pump this blood, leads to right-sided cardiac
enlargement. Xrays and ECGs will indicate right
- Echocardiograms/ultrasound and magnetic
resonance imaging (MRI) will also show right ventricular
hypertrophy. They will also show pulmonary artery
dilatation from the increased blood flow.
- Cardiac catheterization procedures measure
oxygen saturation levels and pressures in the vessels and
ventricles. With VSD, the oxygen saturation level of the
right ventricle is higher than normal, because oxygenated
blood is entering this ventricle through the defect. If
pressure in the pulmonary artery is measured with the
catheter, it will generally be above normal because of
the increased flow in the vessel.
septal defects are commonly diagnosed in the first few days of the neonate's
VSD, the oxygen saturation level may be higher than normal in the right
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