Diagnosis of ventricular septal defect by pulsed Doppler echocardiography. Sensitivity, specificity and limitations.

The M-mode echocardiographic findings of ventricular septal defect (VSD) are nonspecific. A specific pulsed Doppler echocardiographic (PDE) diagnosis of VSD can be made by following the turbulent VSD jet through the septum. To assess the sensitivity, specificity and limitations of PDE diagnosis of VSD, 105 children undergoing cardiac catheterization were examined by PDE. These children had a variety of cardiac defects, and a PDE diagnosis of VSD was made in 46/51 (90%) who had VSD proven at catheterization. There was one false positive PDE diagnosis of VSD, for a specificity of 98%. Factors influencing the ability to diagnose VSD by PDE include the location of the defect, level of pulmonary vascular resistance and direction of blood flow through the VSD. The presence of additional defects did not interfere with PDE diagnosis of VSD. The PDE detection of additional defects may identify situations where M-mode echocardiographic estimation of dimensions may not be indicative of the size of VSD shunt.