Anatomy & Physiology
What is a Ventricular Septal Defect?
A hole in the wall separating the two lower chambers of the heart
What is a common murmur heard with ventricular septal defect (VSD)?
Harsh, holosystolic murmur best heard at the left lower sternal border
What diagnosis tool is most commonly used to confirm VSD?
Echocardiogram (Echo)
What type of VSD often closes spontaneously in infancy?
What is small muscular VSD
What a key sign nurses should monitor that may indicate worsening heart failure?
Tachypnea or increased work of breathing
True or False: A VSD increases pulmonary blood flow
True
What symptom might a newborn with a large VSD show?
What is Tachypnea
What type of heart murmur is typically heard in VSD?
What is Harsh, holosystolic murmur at the lower left sternal border
Name one medication used to reduced fluid overload in infants with VSD?
What is Furosemide (Lasix)
How can a nurse support nutrition in an infant with VSD?
Provide high calorie feeds and consider feeding via NG tube if needed
Which part of the heart is involved in VSD?
What is the muscular wall that separates the left and right ventricles
Name two signs of congestive heart failure in infants?
Tachypnea (rapid breathing) Poor feeding with diaphoresis (sweating while feeding)
Which test uses sound waves to visualize blood flow through the septum?
Doppler echocardiography
A what age is surgical repair typically considered if the VSD does not close naturally?
Around 3-6 months of age (depending on severity and symptoms)
What should parents be taught to watch for at home?
Poor feeding, sweating, rapid breathing, or poor weight gain
Name one congenital syndrome commonly associated with VSD?
What is Down syndrome (Trisomy 21)
How does VSD affect feeding in newborns?
Increased energy demands and respiratory distress
Why might a chest X-ray be ordered in a patient with suspected VSD?
To check for cardiomegaly and increased pulmonary vascular markings
What is the goal of medical management in moderate to large VSD?
Manage heart failure symptoms and support growth until surgery is needed
What infection is a child with VSD at risk for and may need prophylactic antibiotics?
Infective endocarditis
Why might failure to thrive occur in VSD?
What is increased workload on the heart and inefficient oxygen delivery
Why might failure to thrive occur in VSD?
Increased energy demand: The heart works harder to pump blood because of the left to right shunt using more calories
Poor feeding: Infants tire easily and breathe rapidly (Tachypnea), making it hard to feed effectively.
Congestive Heart Failure: Fluid build up in the lungs and body interferes with feeding and digestion
Inadequate caloric Intake: Infants cant consume enough to meet their increased energy needs, leading to poor weight gain
What abnormal finding on an ECG may suggest a large VSD?
Signs of left or right ventricular hypertrophy
what procedure may be used to close a VSD if surgery is not required?
Cardiac catheterization with device (for select cases)
Post-op, what is one critical nursing assessment focus?
Monitor for arrhythmias, bleeding and signs of infection or low cardiac output