Case history
Case history #1
An infant is noted at birth to have a cardiac murmur. Physical exam reveals a systolic murmur at the left sternal border. There is no clinical evidence of heart failure.
Case history #2
An infant presents with symptoms of shortness of breath on exertion, and faltering growth. Physical exam reveals a systolic murmur at the left sternal border and signs of congestive heart failure.
Other presentations
Eisenmenger syndrome presents with central cyanosis, with or without finger clubbing, and patients may have evidence of heart failure and a history of recurrent pulmonary infections. Erythrocytosis develops secondary to cyanosis, subsequently leading to iron deficiency and blood hyperviscosity. Key symptoms of Eisenmenger syndrome include headache, fatigue, dizziness, hemoptysis, atypical chest pain, palpitations, and dyspnea (may be on exertion only).[5] Usually, the patient will have a documented history of a ventricular septal defect (VSD) that was not corrected.
A VSD secondary to myocardial infarction (MI) presents 3 to 5 days after the initial MI with symptoms of heart failure or, in severe cases, cardiogenic shock.[6] Traumatic VSDs can present at a variety of time frames from immediate to delayed. The presence and severity of symptoms depend on the size of the VSD.[1]
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