Echocardiogram: Parasternal long axis view showing a VSD
On examination Sam is pink and well perfused. He has mild subcostal recession and his respiratory rate is 60 breaths per minute. His chest is clear on auscultation. He has a 3/6 pan systolic murmur heart loudest at the left sternal border with no radiation. His abdomen is soft with the liver edge palpable 2cm below the costal margin. His femoral pulses are easily palpable. You conclude that Sam has signs of congestive heart failure.
An echocardiogram is performed and Sam is found to have a moderate size perimembranous ventricular septal defect with left to right flow across it. No other structural abnormalities are found. The left ventricle is mildly dilated (due to the increase in pulmonary blood flow and increased pulmonary venous return) but there is good biventricular systolic function.