Why Echocardiography is Key for CHDs

Echocardiography is the primary imaging tool for diagnosing congenital heart defects (CHDs) in fetuses, newborns, children, and adults. It provides detailed anatomical and functional information about the heart's structure and blood flow, helping identify specific defects and guiding treatment decisions.

How Echocardiography Detects CHDs

• High-Resolution Imaging: Uses ultrasound to create detailed images of heart structures, including chambers, valves, septa, and great vessels.

• Doppler Assessment: Evaluates blood flow direction, velocity, and turbulence, indicating abnormal communications or obstructions.

• Multiple Views: Obtains various views (e.g., parasternal, apical, subcostal) to visualize different heart regions and defects.

• Quantitative Measurements: Measures chamber sizes, wall thickness, valve areas, and pressure gradients to assess defect severity.

Specific CHDs Diagnosed by Echocardiography

1. Atrial Septal Defect (ASD): Detects abnormal openings between atria; uses Doppler to show left-to-right shunting.

2. Ventricular Septal Defect (VSD): Identifies openings between ventricles; Doppler quantifies shunt size and direction.

3. Patent Ductus Arteriosus (PDA): Shows persistent connection between aorta and pulmonary artery; Doppler demonstrates continuous flow.

4. Tetralogy of Fallot: Visualizes overriding aorta, VSD, pulmonary stenosis, and right ventricular hypertrophy.

5. Transposition of the Great Arteries (TGA): Reveals abnormal great vessel origins; critical for prenatal diagnosis.

6. Coarctation of the Aorta: Detects narrowing of the aorta; Doppler shows increased velocity and diastolic runoff.

7. Hypoplastic Left Heart Syndrome (HLHS): Shows underdeveloped left ventricle and aorta; guides surgical planning.

8. Ebstein Anomaly: Demonstrates apical displacement of tricuspid valve and atrialized right ventricle.

9. Atrioventricular Septal Defect (AVSD): Identifies common atrioventricular valve and septal defects.

10. Pulmonary Stenosis/Regurgitation: Assesses valve narrowing or insufficiency; Doppler measures gradients.

Types of Echocardiography Used for CHDs

• Transthoracic Echocardiography (TTE): Standard non-invasive approach for infants, children, and adults.

• Transesophageal Echocardiography (TEE): Provides higher-resolution images, often used intraoperatively or in complex cases.

• Fetal Echocardiography: Screens for CHDs prenatally (~18-22 weeks gestation).

• Contrast Echocardiography: Uses contrast agents to enhance detection of shunts or small defects.

• 3D Echocardiography: Offers three-dimensional views for detailed anatomical assessment.

Benefits of Echocardiography in CHD Management

• Early Diagnosis: Enables prenatal or early postnatal detection, improving outcomes.

• Accurate Anatomical Detail: Defines defect anatomy for surgical or catheter-based intervention planning.

• Hemodynamic Assessment: Quantifies shunt size, pressure gradients, and ventricular function.

• Non-Invasive Monitoring: Allows serial follow-up without radiation exposure.

• Guiding Interventions: Used during catheterization or surgery to guide repairs.

• Prognostic Information: Assesses severity and predicts outcomes.

Limitations and Complementary Tools

• Operator Dependence: Requires skilled sonographers and cardiologists.

• Limited Acoustic Windows: Obesity or postoperative scars may affect image quality.

• Functional Assessment: May need additional tests (e.g., cardiac MRI/CT) for detailed tissue characterization.

• Complementary Imaging: Cardiac catheterization provides hemodynamic data; MRI offers detailed anatomy when needed.

Clinical Impact

• Surgical Planning: Defines anatomy for corrective surgeries (e.g., Norwood for HLHS).

• Timing of Intervention: Determines when catheter-based or surgical repair is needed.

• Post-Operative Follow-Up: Monitors repair integrity, residual defects, and ventricular function.

• Family Counseling: Provides prognostic information and guides prenatal counseling.

At LAVIDA Heart, advanced echocardiography plays a central role in diagnosing and managing CHDs, offering families accurate diagnoses and tailored treatment plans to improve outcomes for children with heart defects.