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Posted On : 13 Feb 2014

how to differentiate clinically between VSD and AVSD

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Answer 1

Clinically it may be difficult if not impossible to differentiate between a VSD and an AVSD but there are some points which may help you suspect an AVSD.

If the child becomes symptomatic very early in life may be within first couple of weeks, if you see prominent V waves in the neck in a child with suspected VSD, if you have A2P2 split which is fixed in a child with a suspected VSD, if you hear an additional apical PSM which is different from the one you are hearing in the left parasternal region and PH which seems to be disproportionate for the age as well as the size of the VSD you could suspect AVSD. Also, the ECG usually shows a left axis deviation with a counterclockwise loop on the ECG {q waves in lead I and aVL. Obviously, echo will give you the final answer. Clinically, you can go only this far and no further. In today`s therapeutic era, you need to define the anatomy of AVSD in great details so that the Surgeon can plan his surgery accordingly, especially in relation to the repair of the AV valves

Bharat Dalvi

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