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Diagnosis of congenital heart disease
Last reviewed: 04.07.2025
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Instrumental methods
Electrocardiography. ECG is important already at the initial stages of diagnostics of congenital heart defects. It is important to evaluate all parameters of a standard ECG.
Changes in the pacemaker characteristics are not typical for congenital defects. Heart rate almost always increases due to hypoxia and hypoxemia. Heart rhythm regularity rarely changes. Heart rhythm disturbances are most often associated with ventricular septal defect, accompanied in some cases by extrasystole, and tricuspid valve malformation (Ebstein's anomaly), accompanied by attacks of paroxysmal tachycardia.
Deviation of the electrical axis of the heart has a certain diagnostic value. When the right ventricle is overloaded, a pathological deviation of the electrical axis of the heart to the right is noted (defect of the interatrial and interventricular septum, tetralogy of Fallot, etc.). Pathological deviation of the electrical axis of the heart to the left is typical for an open aortic duct, an incomplete form of AV communication. Such changes on the ECG can become the first warning signs.
Some types of intraventricular blocks may be symptoms of certain heart defects. For an atrial septal defect, an incomplete right bundle branch block of the rSR type is typical. With Ebstein's tricuspid valve anomaly, a complete right bundle branch block is often encountered.
X-ray examination
Radiography must be performed in three projections - direct and two oblique. The state of the pulmonary blood flow and heart chambers is assessed. The results of the study in topical diagnostics of congenital heart defects are not absolute and are significant only in combination with other diagnostic methods given.
EchoCG. In most cases, this is the decisive method of topical diagnostics of congenital defects. The negative side of EchoCG is the element of subjectivity of the researcher, "an objective method in a subjective assessment."
Phonocardiography, unfortunately, has currently lost its diagnostic significance, but can provide clarification to auscultation data.
Angiography and catheterization of the heart cavities. The method allows determining the pressure in the heart chambers, blood oxygen saturation, the direction of intracardiac discharges, the type of anatomical and functional disorders.
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