Clinical Manifestations?Signsinspection:precordium full,apex beatdiffusionpalpation:systolic thrill（震颤）inL3-4percuss:heart boundary expand inbilateralauscultation:3-4/6 systolic murmur inL3-4P2 strengthen/hyperfunction
Clinical Manifestations Signs inspection: precordium full, apex beat diffusion palpation: systolic thrill（震颤） in L3-4 percuss: heart boundary expand in bilateral auscultation: 3-4/6 systolic murmur in L3-4 P2 strengthen/hyperfunction
Clinical Manifestations+LargeVsDwithpulmonaryresistanceincreasedSymptoms:cyanosis after exercise orcontinue cyanosis, sporadichemoptysis, clubbing,growthdevelopment backwardobviously
Clinical Manifestations Large VSD with p ulmonar y r esistance incr eased S y m p toms: cyanosis after exer cise or continue cyanosis, sp or adic hemop tysis, clubbing, g r o w t h develop men t b ackwar d obviously
Clinical Manifestations?Signsinspection:precordiumhunch（隆 起），apexbeatdiffusionpalpation: systolic thrill in L3-4percuss: heart boundary obviously expand inbilateralauscultation:3-4/6 brief systolic murmur inL3-4,P2strengthen/hyperfunction
Clinical Manifestations Signs inspection: precordium hunch( 隆 起 ), apex beat diffusion palpation: systolic thrill in L3-4 percuss: heart boundary obviously expand in bilateral auscultation: 3-4/6 brief systolic murmur in L3-4,P2 strengthen/hyperfunction
AssistantExaminationesElectrocardiogram(EcG)Small VSD:normalormildLVhypertrophyMorderate-large VSD: LV hypertrophy or bothventricular hypertrophyPA pressure obviously increased: mainly RVhypertrophy
Electrocardiogram(ECG) Small VSD: normal or mild LV hypertrophy Mor der at e-large VSD: LV hypert r ophy or bot h ventricular hypertrophy PA pr es s ur e obviously incr eased: mainly RV hypertrophy Assistant Examinationes
Small VSD:normal or mild LVhypertrophyIⅢIaVRaVLaVFV3112V61/2V21/2V41/2Va1/2
Small VSD: normal or mild LV hypertrophy