Question

CG is a 16-year-old high school student whose parents brought him to the nurse practitioner for a sports physical prior to beginning basketball practice. He has known significant medical history, takes no medications, and has no allergies. CJ does report that he frequently becomes short of breath earlier than most of the boys on the team. He attributes this to needing to get into better physical condition. The physical exam is unremarkable except for a grade III systolic murmur heard over the entire precordium. An echocardiogram and cardiac catheterization reveal a Ventricular Septal Defect (VSD) with moderate pulmonary hypertension.

Describe the pathophysiology of a Ventricular Septal Defect (VSD).

How do Ventricular Septal Defect differ from Atrial Septal Defect (ASD)? Be specific.

What will the medical treatment for CJ and will he be permitted to play basketball?

Answer 1

A ventricular septal defect is a common heart defect most often present at birth. A heart defect due to an abnormal connection between the lower chambers of the heart (ventricles) results in mixing up of blood between right and left side of the heart,

Pathophysiology of Ventricular septal defect:

VSDs are located in the membranous or muscular portion of the ventricular septum and vary in size.
Some defects close spontaneously; in other defects, the entire septum is absent, creating a single ventricle.
As the pulmonary vasculature gradually relaxes, right ventricular pressure decreases, allowing blood to shunt from the left to the right ventricle.

Blood is shunted from the left ventricle directly across the open septum to the pulmonary artery.

2.ASD is an open hole between the top chambers. Here the blood flowing from the higher pressure left atrium to flow into the lower pressure right atrium.

VSD is a heart condition in which an opening in the septum between the ventricles allows blood to shunt between the left and right ventricles.

3. Device closure during cardiac catheterization, to repair the hole, the doctor moves a small mesh device through the catheter to the site of the defect. The device is designed to flatten against the septum on both sides to close and permanently seal the hole. It will stay in the heart permanently. The catheter is then removed.