Doppler echocardiography in adults with isolated ventricular septal defect

Doppler echocardiography and cardiac catheterization were undertaken in 70 consecutive patients, 31-68 years of age (mean 39), who had isolated congenital ventricular septal defects (VSD), 28 of whom had been operated upon. In 50 patients with invasively proven VSD, 37 had a correct Doppler diagnosis of VSD (group 1) and in 13 a false negative result was obtained (group 2); i.e. a sensitivity of 74%. No false positive Doppler diagnosis was made in the 20 patients without evidence of shunt. Left to right ventricular systolic pressure difference (delta P) ranged between 55 and 142 mm Hg, with a mean value of 103 mm Hg in group 1 and 99 mm Hg in group 2. There was good correlation between delta P obtained by continuous wave Doppler and catheterisation in 17 group 1 patients with moderate and large shunts (r = 0.81, P less than 0.001). There was no correlation in the remaining 20 patients in group 1 with small shunts (r = 0.20, P greater than 0.1). Doppler echocardiography in the adult with isolated VSD has good sensitivity and excellent specificity. Doppler prediction of delta P is reasonably correct in patients with moderate and large shunts, but of no value in patients with small shunts.