Ventricular septal defect

About 20% of congenital heart disease may exist independently, can coexist with other deformities. [Autopsies -- According to the defect location, it can be divided into five types : 1, Room crest defect in the right ventricular outflow tract. Room on the ridge above and the main pulmonary valve, with a small number of cases, aortic and pulmonary valve regurgitation. 2, Room ridge under ventricular septal defect in the Department of Film, the most common type, accounting for about 60-70%. 3, septal valve defect in the right ventricular inflow tract, tricuspid valve rear, or about 20%. 4, muscular defect in apical to the trabecular muscle defect, systolic myocardial contractility time separated so that smaller defect, Therefore, left-to-right flow of small hours. 5, the common membranous ventricular septal and not muscular development, or for the number of defects, less frequent. Ventricular septal defects, defects in 0.1~3cm, at the Department of Membrane they were larger, muscular were smaller the latter also known as Roger's disease. If the defect "0.5cm sub flow of smaller, more no clinical symptoms. Minor defect to the right ventricular increased mainly large left ventricular defect over the right ventricle increased significantly. [Pathophysiological -- ventricular levels in the left to right shunt, the number of hours depends on the flow of defect sizes. Large defect, pulmonary blood flow was significantly increased inflow of the left atrium and rooms, the level of the ventricular defect exports again through the right ventricular inflow. into the pulmonary circulation, which left and right ventricular overload, the left and right ventricle increased, pulmonary blood flow leading to increased pulmonary artery pressure, right ventricular systolic load is on the rise, eventually enter obstructive pulmonary hypertension period, there will be two-way or right-to-left shunt. ??Performance -- a clinical symptoms defect, which can be asymptomatic. Major defects, and early onset of symptoms significantly, thus affecting development. Asthma is palpitations, fatigue easy lung infection. Severe heart failure can occur. Marked pulmonary hypertension, there will be cyanosis, suffering from the disease easily infectious endocarditis. 2, signs apexcardiogram enhance translocation to the lower left, the left heart sector expanded, Typical signs of the left sternal edge III-IV intercostal a 4-5 Rough-systolic murmur to the heart conduction region before, with systolic small tremor. If sub-flow, the apex may have functional diastolic murmur. Pulmonary valve and the second sound hyperthyroidism split. Severe pulmonary hypertension, pulmonary valve area relative pulmonary valve insufficiency of diastolic murmur. septal defect in the original systolic murmur can be weakened or disappeared. ??Laboratories and other inspection -- a small X-ray heart defects affect more than no change. Moderately large defects, cardiac varying degrees increased, mainly to the right ventricle. Large defect, the left and right ventricle were increased, the pulmonary trunk abdomen, pulmonary vascular enhanced video, severe pulmonary hypertension, lung field with a distinct lateral. 2, ECG defect minor ECG abnormalities. More moderately large defect, said the left or right ventricle, right ventricular hypertrophy. 3, echocardiographic left atrium, left ventricle and right ventricle diameter increased septal Echo continuous interruption, Doppler ultrasound : from the right ventricular defect-oriented na hole and left ventricular surface tracking can be of the greatest test of turbulence. 4, cardiac catheterization right ventricular oxygen content level higher than the 0.9% volume right atrium above, Occasionally catheter can be reached through the left ventricular defect. According to the number of hours the flow, pulmonary or right ventricular pressure increased to varying degrees. [Diagnosis -- according to the typical signs, X-ray, ECG, echocardiography and cardiac catheterization and other tests can be diagnosed, But attention to the disease when combined with patent ductus arteriosus. The latter is often the cacophony of ventricular septal defect covered by the loud noises, and easily missed. for the valve or ventricular septal defect - where, because of the left to right shunt blood to flow directly into the pulmonary artery, induced pulmonary oxygen content above the right ventricle and easily misdiagnosed as patent ductus arteriosus. It may, if necessary, or for the diagnosis of aortic angiography. [Differential diagnosis -- an atrial septal defect primary hole-see closure of atrial septal defect Festival. 2, pulmonary stenosis pulmonary stenosis pulmonary patients Second sound normal or reduced. X-ray showed pulmonary vascular video scarce, right heart catheterization without segregation, and the right ventricle and pulmonary artery between systolic pressure gradient. 3, hypertrophic obstructive cardiomyopathy obstructive cardiomyopathy to jet noise, loud posture and breathing with the change, X-ray showed pulmonary trunk does not eviscerate, pulmonary vascular little impact. 4, Room on the crest of ventricular septal defect-in aortic valve, make aortic valve lost support where aortic insufficiency, and required the attention of patent ductus arteriosus. aortic sinus aneurysm ruptured into the right ventricle, the main pulmonary artery defect identification. Right heart catheterization, right ventricular level triage or aortic angiography showed a contrast agent left ventricular regurgitation, the right ventricular early enhancement. [1] treatment, medical treatment of major combat infectious endocarditis, a lung infection and heart failure. 2, open heart surgical treatment downlink defect, a small defect, X-ray and ECG were normal without surgery. If / or without pulmonary hypertension, left to right shunt, the operation the best effect, it is advisable to 4-10 years, If early symptoms or heart failure, but also in infants surgery, significant pulmonary hypertension, two - or right-to-left shunt mainly, it is inadvisable to surgery.