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ANSWERS
1. a. A high ventricular septal defect, membranous type, the most common type; much less frequent in the muscular septum. With the high pressure differential, a small defect can result in a large left-to-right shunt.
2. Trauma to the endocardial surface from hemodynamic disturbances results in a jet lesion (in this case, the jet lesion would be at the point where, due to the septal defect, the high pressure flow from the left ventricle hits the right ventricle wall); this damaged area is then more susceptible to infective endocarditis just as any abnormal valve is more susceptible.
3. a. Spontaneous closure can occur with small defects.
b. Eventually if this does not occur and the defect is not repaired, severe pulmonary hypertension with shunt reversal and cyanosis (Eisenmenger syndrome) can occur.
WebPath Case Review:
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