Clinical Findings in a Patient with a Ventricular Septal Defect (VSD)

A patient with a ventricular septal defect (VSD) may or may not present with clinical signs and symptoms.

Size of VSD as Percent of Aortic Annulus	Defect Size
< 25%	small
25 to 75%	moderate
> 75%	large

Clinical findings may include:

(1) systolic murmur

(2) infective endocarditis

(3) shunt

(4) left ventricular overload

(5) heart failure

(6) pulmonary arterial hypertension (PAH)

(7) aortic or tricuspid valve regurgitation

(8) subpulmonary stenosis

(9) subaortic stenosis

(10) thromboembolic events

(11) heart block or arrhythmia (if treated)

Finding	Small Defect	Moderate Defect	Large Defect
shunt	small left-to-right	small to moderate left-to-right	moderate to large left-to-right, or right-to-left
left ventricular overload	none	mild to moderate	marked
heart failure	none	none to mild	moderate to marked
PAH	none	none to mild	moderate to marked

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