Small muscular ventricular septal defect – echocardiogram
Echocardiogram in apical 5 chamber view shows the mosaic colour jet of a small ventricular septal defect (VSD) near the apex. The cardiac chambers are not dilated. The small defect is difficult to see on two dimensional echocardiography, though it is easily detected clinically with a pan systolic murmur and Doppler echo documents the high velocity jet across the VSD. LV: Left ventricle; RV: right ventricle; Ao: Aorta; LA: Left ventricle; Pulm vein: Pulmonary vein.
Continuous wave (CW) Doppler interrogation shows the inter-ventricular pressure gradient as 81 mm Hg, which is consistent with a restrictive VSD. Small muscular VSDs like this are likely to close spontaneously on follow up. They will not cause pulmonary hypertension or heart failure and usually have good prognosis unless complicated by infective endocarditis.