Diagnosis of congenital heart defects
Last reviewed: 23.04.2024
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Instrumental methods
Electrocardiography. ECG is important already at the initial stages of diagnosis of congenital heart disease. It is important to evaluate all parameters of the standard ECG.
The change in the driver's characteristic of rhythm for congenital malformations is not typical. The frequency of the heart rhythm due to hypoxia and hypoxemia almost always increases. The regularity of the heart rate rarely changes. With violations of the heart rhythm, the defect of the interventricular septum is often associated, accompanied in some cases by extrasystole, and the anomaly of the development of the tricuspid valve (Ebstein's anomaly), accompanied by attacks of paroxysmal tachycardia.
A certain diagnostic value is the deviation of the electrical axis of the heart. When the right ventricle is overloaded, a pathological deviation of the electric axis of the heart to the right (defect of the interatrial and interventricular septum, tetralogy of Fallot, etc.) is noted. The pathological deviation of the electrical axis of the heart to the left is typical for the open aortic duct, the incomplete form of AV communication. Such changes on the ECG can be the first warning signs.
Some variants of intraventricular blockades may be symptoms of certain heart defects. For an atrial septal defect, the incomplete right bundle branch block is of the rSR type . In the case of an abnormality of the Ebstein tricuspid valve, a complete blockage of the right leg of the bundle of His is often encountered.
X-ray examination
Radiography should be carried out in three projections - straight and two oblique. Assess the state of pulmonary blood flow and chambers of the heart. The results of the study in the topical diagnosis of congenital heart disease are not absolute and only in combination with other diagnostic methods.
Echocardiography. In most cases, this is the decisive method of topical diagnosis of congenital malformations. The negative side of the echocardiogram is an element of the subjectivity of the researcher, "an objective method in the subjective evaluation."
Unfortunately, at the present time, phonocardiography has lost its diagnostic significance, but it can make corrections to the auscultation data.
Angiography and catheterization of the heart cavities. The method allows to determine the pressure in the chambers of the heart, the saturation of blood with oxygen, the direction of intracardiac discharges, the type of anatomical and functional disorders.
[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12],