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Radiology
Ventricular Septal Defect
Built from Obstetric Imaging
What’s inside
7 sections · 54 slides
Overview
- What this deck covers
The defect, and why it matters
What the hole is, how common it is, and what it signals
- A hole between the two pumping chambers
- Why the site of the hole is the question
- 3-5
- Top of one list, bottom of the other
- What causes it
- A VSD on a fetal scan is a signpost
Four types, one septum
Each type is named for the part of the wall it sits in
- Four types, named by where the hole sits
- Where each type of defect sits in the septum
- Perimembranous: the common one
- Inlet: low and behind
- Muscular: a hole in the thick part
- Two muscular defects, one landmark
- Infundibular: between the two exits
- The four types at a glance
- Perimembranous defects split again
How the blood behaves
Quiet before birth, busy afterwards
- Before birth the hole barely does anything
- What changes the moment the baby is born
- Three things set the size of the shunt
- When a long-standing shunt turns dangerous
Seeing it on ultrasound
The views, the angle, and why colour Doppler is not optional
- What a defect looks like on the screen
- Why the hole is hard to size
- Which view finds which defect
- How to hunt for a defect
- Get the angle right
- Colour Doppler: the tool that finds small holes
- Pulsed-wave Doppler: proving the shunt
- Inlet defect on the four-chamber view
- Muscular defects shown by colour Doppler
- Midmuscular defect, above the moderator band
- Apical defect, below the moderator band
- Small perimembranous defect below the aortic valve
- Well aligned and malaligned defects side by side
- The well aligned defect, up close
- The malaligned defect, up close
- Bidirectional shunt on pulsed-wave Doppler
- Adding the third dimension
- Classic signs to remember
Look-alikes
Two diagnoses that can hide behind a septal defect
- Tetralogy of Fallot
- Atrioventricular septal defect
After the diagnosis
Workup, genetics, follow-up and outcome
- What happens once a VSD is seen
- Which defects warrant a genetic study
- Pregnancy care does not change
- Some holes close before birth
- After birth, most small holes shut
- Who needs treatment
- How closure is done, and where it is heading
- What the referring physician needs to know
- What the referring physician needs to know, continued
- Key points
- References
- References (continued)
- Suggested reading
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition