Ventricular Septal Defect

Key points

• VSDs are the most common cause of congenital heart disease and close spontaneously in around 50% of cases.
• Congenital VSDs are associated with chromosomal disorders (Down's, Edward's, Patau syndromes) and single gene disorders; non-congenital causes include post-MI.
• Classically a pan-systolic murmur which is louder in smaller defects.
• Complications: aortic regurgitation (poorly supported right coronary cusp → cusp prolapse) · infective endocarditis · Eisenmenger's complex · right heart failure · pulmonary hypertension.
• Pulmonary hypertension contraindicates pregnancy — it carries a 30–50% risk of mortality.

Decision points in this pathway

• Pulmonary hypertension present in a woman planning pregnancy?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.