Ventricular Septal Defect

  • Leonel E. Ampie
  • Suliman EL-Amin


Ventricular Septal Defects (VSD) represent the most common congenital heart malformation which comprises approximately 20 % of inborn heart defects. Size and location are distinguishing factors which are determined by the auscultative quality of the murmurs as well as key physical exam findings. Other diagnostic modalities which supplement physical exam findings include: EKG, chest X-ray, and echocardiography. Once the septal severity is determined, the prognosis of the patient can be properly gauged and the required therapeutic approach may be implemented. This chapter outlines the etiology, key auscultation features, diagnostic testing, management, and prognosis of VSDs.


VSD Ventricular Septal Defect Congenital defect Graham-Steell murmur Eisenmenger’s syndrome Inching Technique 

Supplementary material

310603_1_En_25_MOESM1_ESM.mp4 (4.6 mb)
Video 25.1 VSD murmur in a 15-year-old boy, as described by Dr. W. Proctor Harvey (File 271 from Clinical Cardiology by W. Proctor Harvey, MD, MACC, Jules Bedynek, MD, and David Canfield and published by Laennec Publishing Inc., Fairfield, NJ. Used with permission and copyrighted by Laennec Publishing, Inc. All rights reserved) (MP4 4665 kb)
310603_1_En_25_MOESM2_ESM.mp4 (1.1 mb)
Video 25.2 Large VSD: Harsh holosystolic murmur and soft mid-diastolic rumble. (Provided by Robin Winkler Doroshow, MD, Medstar Georgetown University Hospital, Washington, DC.) (MP4 1169 kb)
310603_1_En_25_MOESM3_ESM.mp4 (1.4 mb)
Video 25.3 Small VSD: high-pitched short SEM (Provided by Robin Winkler Doroshow, MD, Medstar Georgetown University Hospital, Washington, DC) (MP4 1431 kb)


  1. 1.
    Hoffman J, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39:1890–900.CrossRefPubMedGoogle Scholar
  2. 2.
    Chizner M. Cardiac auscultation: rediscovering the lost art. Curr Probl Cardiol. 2008;33:326–408.CrossRefPubMedGoogle Scholar
  3. 3.
    Minette M, Sahn D. Ventricular septal defects. Circulation. 2006;114:2190–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Kidd L, Driscoll DJ, Gersony WM, Hayes CJ, Keane JF, O'Fallon WM, Pieroni DR, Wolfe RR, Weidman WH. Second natural history study of congenital heart defects. Results of treatment of patients with ventricular septal defects. Circulation. 1993;87:I38–51.CrossRefPubMedGoogle Scholar
  5. 5.
    Gabriel HM, Heger M, Innerhofer P, Zehetgruber M, Mundigler G, Wimmer M, Maurer G, Baumgartner H. Long-term outcome of patients with ventricular septal defect considered not to require surgical closure during childhood. J Am Coll Cardiol. 2002;39:1066.CrossRefPubMedGoogle Scholar
  6. 6.
    Griffin MR, Wilson WR, Edwards WD, O’Fallon WM, Kurland LT. Infective endocarditis. Olmsted County, Minnesota, 1950 through 1981. JAMA. 1985;254:1199–202.CrossRefPubMedGoogle Scholar
  7. 7.
    Perloff JK. Ventricular septal defect. In: Perloff JK, editor. The clinical recognition of congenital heart disease. Philadelphia: WB Saunders; 1994. p. 396–439.Google Scholar
  8. 8.
    Ammash N, Warnes C. Ventricular septal defects in adults. Ann Intern Med. 2001;135:812–24.CrossRefPubMedGoogle Scholar
  9. 9.
    McDaniel NL. Ventricular and atrial septal defect. Pediatr Rev. 2002;22(8):265–70.CrossRefGoogle Scholar
  10. 10.
    Phoon CK. Estimation of pressure gradients by auscultation: an innovative and accurate physical examination technique. Am Heart J. 2001;141(3):500–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Georgetown University School of Medicine, Georgetown University HospitalWashingtonUSA

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