Most common heart abnormality in child –
Correct Answer: Ventricular septal defect
Description: Ans. is 'b' i.e., Ventricular septal defect Ventricular septal defect (VSD)o VSD is the most common congenital heart disease. There is a communication between two ventricles. VSD may be located at:-i) Membranous part of interventricular septum (called membranous VSD): Most common.ii) Muscular septum (muscular VSD).o VSD is more common in females.Clinical manifestation of VSDo The patients become symptomatic around 6 to 10 weeks of age.o At this time CHF may developo Frequent symptoms - Palpitation, dysnea on exertion and chest infections.o Symptoms of CHF improve and cyanosis develops once pulmonary vascular resistance increases above systemicvascular resistance (Eisenmeneger physiology).Signso Hyperkinetic precordium with a thrill at the left sternal bordero Pansystolic murmur at left sternal border.o S1 & S2 are masked by pansystolic murmur maximum intensity of murmur is at 3rd, 4th or 5th left interspaceo S2 can be make out at pulmonary area (upper left sternal border) where it is not masked by pansystolic murmur - S2 is widely split with accentuation of P2.o S3 may be audible at apexo A delayed diastolic murmur in mitral areao Pulmonary systolic ejection murmur in pulmonary area.Course and complicationso 70 to 80% of all VSDs become smaller in size or disappear simultaneously, i.e. spontaneous closure of VSD. Large VSD may have some complication :i) Infective endocarditis (PGI 98)ii) Pulmonary hypertensioniii) CHFiv) Aortic regurgitation.o VSD is the most common congenital heart defect complicated by infective endocarditis
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Pediatrics
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