pediatrics
Ventricular Septal Defect (VSD)
Diagnosis of VSD
Chest x-ray and ECG Echocardiography Diagnosis of ventricular septal defect is suggested by clinical examination, supported by chest x-ray and ECG, and established by echocardiography. If the VSD is large, chest x-ray shows cardiomegaly and increased pulmonary vascular markings. ECG shows right ventricular hypertrophy or combined ventricular hypertrophy and, occasionally, left atrial enlargement. ECG and chest x-ray are typically normal if the VSD is small. Two-dimensional echocardiography with color flow and Doppler studies establishes the diagnosis and can provide important anatomic and hemodynamic information, including the defect’s location and size and right ventricular pressure. Cardiac catheterization is not necessary for diagnosis but may be used to evaluate the degree of pulmonary hypertension and pulmonary overcirculation and assess pulmonary vascular resistance. 