Murmur in Ventricular Septal Defect (VSD)

Murmur in VSD depends on the size of VSD. Depending on the size of VSD it may produce either pansystolic murmur or early systolic murmur.

• Murmur in trivial defct à produces – high pitched early  systolic decrescendo murmur at lower left sternal border.
• Small defect produce high pitched pansystolic murmur at the LLSB.
• Moderate defect produce high pitched pansystolic murmur at the LLSB.
• Large defect produce high pitched pansystolic murmur at the LLSB.
• VSD with PAH à high pitched early systolic decrescendo murmur.
• Eisenmenger VSD  high pitched early systolic decrescendo murmur.

So VSD with early systolic murmur is heard in

1. Trivial VSD
2. VSD with PAH
3. Eisenmenger VSD

What is the basis for pansystolic murmur with midsystolic accentuation in large VSD

Rapid ejection of large stroke volume into the dilated pulmonary artery produces pulmonary flow murmur. It is the cause for midsystolic accentuation.

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2. Anatomical classification of Ventricular septal defect
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4. Murmur in Ventricular Septal Defect (VSD)
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7. Pathophysiology of ventricular septal defect (VSD)