[Verse 1] Hold the ruler up against the aorta's width, a whisper-hole is small, barely moves a myth, moderate's the middle child, shunting steady flow, large as the vessel itself, that's the one to watch and know. Size decides the volume, how much blood will cross, small might close on its own, large one bears a cost. [Chorus] Measure the size, feel the squeeze, count every hole hiding in the Swiss cheese, watch how the septum leans and steers— these are the clues that shape the coming years. Size and squeeze and shape and steer, say it soft and keep it clear. [Verse 2] A restrictive defect throttles down the flow, pressure drops like water through a narrow, needled hole, high-velocity cataract, a thin and singing jet, the lungs stay dry and guarded, no pressure debt. But non-restrictive opens wide, no gate to hold it back, the right side inherits systemic, off the beaten track, same numbers as the body, no shelter, no disguise— the pulmonary bed pays for a defect of that size. [Chorus] Measure the size, feel the squeeze, count every hole hiding in the Swiss cheese, watch how the septum leans and steers— these are the clues that shape the coming years. Size and squeeze and shape and steer, say it soft and keep it clear. [Verse 3] Sometimes it's only one clean window, tidy, sealed, and plain, sometimes the muscle's labyrinthine, riddled like a drain, multiple little tunnels, a maze inside the wall— one patch won't catch them, closure means chasing all. Count them before you promise a simple, single fix, the Swiss cheese pattern warns you: this repair's a mix. [Verse 4] Now the outlet septum, watch which way it tips, lean it toward the right and the outflow narrows, grips, that's your Fallot pattern, the boot-shaped silhouette scrawled, lean it toward the left instead, the arch may be too small— posterior malalignment, obstruction down the line, a coarctation cousin, or interruption's warning sign. Malalignment isn't quiet, it's a conotruncal flare— a signal that the trunk and cone were sculpted unfair. [Bridge] Some VSDs stand alone, an island, clean and neat, others join a crowded chart, a lesion incomplete— part of something larger, tetralogy, or worse, read the whole anatomy before you write the verse. Isolated or entangled, ask it every time, management bends around the company it keeps in rhyme. [Chorus] Measure the size, feel the squeeze, count every hole hiding in the Swiss cheese, watch how the septum leans and steers— these are the clues that shape the coming years. Size and squeeze and shape and steer, say it soft and keep it clear. [Outro] Small or large, restrictive, free, one hole or a colony, lean left, lean right, alone, or paired— that's the shape of how a heart is repaired.
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