Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
How is a VSD diagnosed? What are the symptoms of a VSD?
The diagnosis of a VSD is usually suspected clinically by hearing a characteristic heart murmur. A murmur is a sound generated by abnormally turbulent flow of blood through the heart. This murmur is the result of blood being shunted through the VSD from the higher-pressure left ventricle into the lower-pressure right ventricle. At birth, this pressure imbalance is minimal and does not usually develop until later in the first week of life. As such, it is rare for a doctor to hear the murmur of a VSD until the baby is a few days of age.
The evaluation of a child with a possible VSD is designed to confirm the diagnosis but also to check for other anatomical defects in the heart and to estimate the size of the shunt of blood from the left to right ventricle.
Such an evaluation usually begins with an electrocardiogram (EKG, sometimes also abbreviated ECG)
and possibly a chest X-ray. A soundwave test of the heart (echocardiogram) is used to define the anatomy and evaluate the characteristics (amount and pressures) of the shunted blood. With the advent of superb echocardiography, the previously required cardiac catheterization is rarely necessary.
What if the VSD is small?
Small defects (less than 0.5 square cm) are common. With a small VSD, there is minimal shunting of blood and the pressure in the right ventricle remains normal. Since the right ventricular pressure is normal, there is no damage to the lung arterioles. The heart functions normally. A prominent murmur heard through a stethoscope is usually the only sign that brings the VSD to attention. This murmur is commonly noted during the first week of life.
A heart murmur is the sound generated when blood flow within the heart is not smooth. Causes of heart murmurs can be functional, congenital, or caused heart valve conditions. Symptoms of a heart murmur may be none, or may include chest pain, shortness of breath, and arm, leg, and ankle swelling. Treatment of a heart murmur depends on the cause.
Birth defects have many causes and currently, are the leading cause of death for infants in the first year of life. Some of the causes of birth defects include genetic or chromosome problems. Exposure of the mother to rubella or German measles during pregnancy, or using drugs or alcohol during pregnancy. The treatment for birth defects depends upon the condition of the effected child.
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