A large membranous ventricular septal defect (VSD) is present as seen from the left ventricle below the aortic valve. About 90% of VSDs involve the membranous septum, with the remainder in the muscular septum. About 30% of VSDs occur as isolated defects, initially without cyanosis, while the remainder are part of multiple malformations, such as tetralogy of Fallot. Some of the smaller VSDs, particularly those in the muscular septum, will close spontaneously. Larger defects require surgical repair. If not treated, VSDs create a left-to-right shunt, cardiac enlargement, congestive heart failure, and arrhythmias. The abnormal shunt increases the risk for infective endocarditis. Large shunts may lead to pulmonary hypertension that can reverse the shunt, a so-called Eisenmenger complex.
There were 75 correct entries out of 158 total entries for case 53.
| Our winner is: Dr.med Dragomir Cuk of Ruma, YUGOSLAVIA
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