BIOMED
Pathophysiology
Everything be alphabetical here (except for Homeostasis at the bottom) 😘
(& Mental Health, Lmao)
There are a lot of neonatal conditions covered, seen in high level NICU/NCCU Units.
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Table of Contents:
1 | Ageing
2 | Canc...
A VSD is essentially a hole (defect) between the ventricles in the heart, that leads to a shunting of blood between the chambers of the heart. This defect may occur in a number of sizes and locations, and these determine how it will be treated.
In VSD, oxygenated blood from the left ventricle shunts across into the right ventricle, causing abnormally high pressures due to enlargement of both the ventricles and the pulmonary artery.
VSDs are among the most common congenital heart defects, and are one of the most common reasons for infants to see a cardiologist. Small defects rarely cause problems, and are generally discovered by noticing a heart murmur on examination. However in VSD, this murmur is not often present in the first few days of life.
Further, most defects will close on their own, especially if they are situated in the muscular portion of the septum, rather than the fibrous tissue. In the even that they don't close however, these holes rarely cause health problems and the child should continue to see cardiology for occasional checkups and monitoring.
Large defects however can cause health problems that often redevelop gradually in the first few months of life.
Normal Physiology Before birth, fetal pressure on the right and left side of the heart is equal, however the moment the baby takes its first breath after birth, the pressure in the lungs and the right side of the heart begins to decrease. This is a slow process that takes about 2-4 weeks to reach a normal level of pressure in the lungs.
Pathophysiology Therefore, in babies with large ventricular septal defects, as the pressure in the right side of the heart decreases, blood from the left ventricle will begin to flow along the path of least resistance—through the septal defect into the right ventricle, and into the pulmonary artery to the lungs. This gradually leads to symptoms of congestive heart failure and must be treated.
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Symptoms Symptoms of VSD are primarily related to excess blood flow to the lungs, however may be absent in small and moderate sized defects.
☞ Heart murmurs are not often heart at birth, but as pressure int he heart changes and blood begins to shunt across tyhe chambers, cardiologists may be able to estimate the location and size of a VSD just by the sound of the murmur. Smaller defects may make a louder noise than larger defects, and the murmur may become louder as the VSD closes.
☞ Signs and symptoms of congestive heart failure with moderate to large VSD's, with excessive blood flow to the lungs. Baby's growth will be the most important sign of this, as these babies will fail to thrive and have difficulty maintaining normal weight gain in the first few months of life.
