Dear Doug,
1. Yes there is a difference between mildly dilated right ventricle (RV) and dilated cardiomyopathy. A mildly dilated RV is non-specific and not generally serious or necessarily the start of something worse whereas a dilated cardiomyopathy is a serious condition.
2. Tne EF would still be the same with VSD. Right sided function can also be seen on the echocardiogram. The "gold standard" for the RV is a right heart cath.
3. Generally a small VSD would not cause much dilation but it is possible.
4. Right ventricular dilation is not that common but neither is it uncommon.