RT Book, Section A1 Bashore, Thomas M. A1 Granger, Christopher B. A1 Jackson, Kevin P. A1 Patel, Manesh R. A2 Papadakis, Maxine A. A2 McPhee, Stephen J. A2 Rabow, Michael W. SR Print(0) ID 1175809307 T1 Ventricular Septal Defect T2 Current Medical Diagnosis & Treatment 2021 YR 2021 FD 2021 PB McGraw-Hill Education PP New York, NY SN 9781260469868 LK accessmedicine.mhmedical.com/content.aspx?aid=1175809307 RD 2023/05/27 AB ESSENTIALS OF DIAGNOSISA restrictive VSD is small and makes a louder murmur than an unrestricted one, often with an accompanying thrill. The higher the gradient across the septum, the smaller the left-to-right shunt.Small defects may be asymptomatic.Larger defects result in pulmonary hypertension (Eisenmenger physiology) if not repaired or if the pulmonary circuit is not protected by RV outflow tract obstruction.Echocardiography/Doppler is diagnostic.