Archive Of Standardized Exam Questions: Ventricular Septal Defect (VSD)


This page is dedicated to organizing various examples of standardized exam questions whose answer is ventricular septal defect (VSD). While this may seem a odd practice, it is useful to see multiple examples of how VSD will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a traditional question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.


When it comes to standardized exams, each condition has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for VSD

  • Patient symptoms: this will all depend on the SIZE of the VSD 
    • No symptoms: patients with a small VSD will not complain of any symptoms or have episodes of cyanosis 
    • Serious complications: patients with a large VSD may have heart failure, failure to thrive, and diaphoresis when feeding. 
  • Heart murmur: 
    • NOT usually detectable at birth  however may become more evident as time goes on (and pulmonary vascular resistance continues to decline). 
    • Holosystolic murmur: can be described as high pitched/blowing
    • Heard best at left sternal border: can have a palpable thrill here. 
    • Apical diastolic rumble may be present as well (increased flow across the mitral valve)
    • Radiates to the precordium

Question # 1


Explanation # 1


Question # 2


Explanation # 2



Many questions on standardized exams go beyond simply recognizing the underlying condition. Often there are specific testable facts regarding some aspect of the disease’s pathophysiology/management/clinical implications that are commonly asked. Some of these are listed below:

  • Treatment:
    • Most small VSDs are insignificant and close on their own. 
    • Large VSDs rarely close on their own and require surgical correction
  • Complications:
    • Eisenmenger syndrome: large VSDs (if left untreated) can cause pulmonary vascular resistance to increase over time, eventually causing a right to left shunt. 



Page Updated: 04.02.2017