DIFFERENTIATION OF APICAL VENTRICULAR SEPTAL DEFECTS (VSD) FROM MITRAL REGURGITATION(MR) BY PULSED DOPPLER ECHOCARDIOGRAPHY (PDE)

Abstract

Thirty-six youngsters with apical systolic murmurs, whose clinical evaluations did not allow conclusive differentiation between VSD and MR were studied by PDE. The PDE technique, which supplements M-mode echocardiography with Doppler flow detection, allowed determination of the site of turbulent blood flow in 35/36, 97%;. Twenty-one had PDE findings of VSD but no MR, and all 10 who underwent cardiac catheterization had VSD demonstrated. Fourteen youngsters had PDE findings of MR but no VSD, and all 5 who underwent catheterization were found to have MR but no VSD. One youngster had both VSD and MR demonstrated by PDE and catheterization. and one had no abnormalities detected by PDE or invasive study. The sensitivity and specificity of PDE for determining the origin of troublesome apical murmurs has obvious clinical utllity.

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