<s>[INST] I recently had a echocardiogram - left ventricular and diastolic dimensions are near the upper limits of normal systolic function. There is a sub aortic ventricular defect with predominant left-right shunting. Blood flow in the right ventricular outflow tract is turbulent and mildly increased. The peak VSD velocity is 5.8 m/second consistent with intraventricular gradient of 134 mmHg in systole. The left atrium is mildly enlarged. Normal right ventricle and atrium. The interatrial septum is intact. There is no evidence of pulmonary hypertension. I am waiting to see the cardiologist but in the meantime my legs, ankles and feet have been sore for two weeks - I have always exercised and walked but lately feel very tired and sore - how serious is my condition and how long should I wait to be seen - thx [/INST] Hello, You have a high peri-membranous ventricular septal defect but no evidence of pulmonary hypertension. Hence, a favorable prognosis. Cardiac catheterization may be required to assess the hemodynamic significance of VSD.  VSD closure of a semimembranosus or outlet VSD is done when associated with more than mild aortic regurgitation and a history of recurrent endocarditis. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor.  </s>