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What are the clinical features of ventricular septal defect (VSD)?

Clinical features of VSD depends on the size of septal defect.
Small VSD is asymptomatic.
Moderate and large VSD may present as dyspnoea on exertion, palpitation or recurrent chest infections.

Following are the clinical signs in VSD
  1. Pulse is hyperkinetic in moderate to large VSD due to the vigorous left ventricular ejection.
  2. Apex is forceful with cardiomegaly.
  3. JVP in moderate to large VSD is prominent with a-v waves.
  4. But in VSD with Eisenmenger syndrome small a wave is seen.
  5. Systolic thrill is felt at lowersternal border.
  6. Wide split of S2.
  7. Left ventricular S3 is present.
  8. Pansystolic murmur is heard at the lowersternal border.
  9. There  may be  middiastolic flow murmur at apex.