pediatrics
Double Outlet Right Ventricle
Diagnosis of Double Outlet Right Ventricle
Chest x-ray and ECG Echocardiography MRI and CT Cardiac catheterization The ECG consistently shows right ventricular hypertrophy with right axis. If the pulmonary outflow and pulmonary valve are unobstructed, the chest x-ray shows cardiomegaly and increased pulmonary vascularity. Conversely, in the presence of pulmonary stenosis, heart size may be normal and pulmonary vascular markings normal or decreased. Echocardiography demonstrates the anatomy well, showing the size and location of the VSD, arrangement of the aortic and pulmonary arteries, and the presence or degree of pulmonary stenosis, either below or at the valve level. MRI or CT is valuable in planning surgical intervention by providing details of the spatial relationships of the VSD and great vessels. Cardiac catheterization may have a role in defining the hemodynamics, including any gradient across the VSD, pulmonary artery pressure, and vascular resistance. 