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Because children with a VSD often have no symptoms, the VSD is usually first noticed during routine testing or medical check-ups. Most commonly, it is found when a physician uses a stethoscope to listen for a heart murmur. However, not all heart murmurs are signs of a VSD. Therefore, the physician will often listen to the patient’s heart a number of times over a 6- to 12-month period before ordering further testing.
An echocardiogram of the heart and major arteries is often the next test to find a possible VSD. This test uses sound waves to visualize the structure and function of the heart. A moving image of the patient’s beating heart is played on a video monitor, where a physician can study the heart’s thickness, size and function. The image also shows the motion pattern and structure of the four heart valves revealing any potential leakag e (regurgitation). During this test, a Doppler ultrasound may also be done to evaluate blood flow in the coronary arteries, the blood vessels of the arms and legs, and the carotid arteries in the neck. The technique can also measure pulmonary artery pressure as well as the volume of blood being pushed through the defect.
Other tests that may be performed include:
- Chest x-ray. A noninvasive test that allows the physician to see if the heart is enlarged and there is fluid in the lungs.
- Electrocardiogram (EKG). This test measures the electrical output of the heart, which is depicted on a sheet of paper. The EKG can help the physician detect signs of an enlarged left ventricle.
- Cardiac catheterization. During this test, a catheter is introduced into the body through a vein (usually in the groin) and threaded all the way up the heart, where it is used to inject a special contrast dye that is visible under x-ray. This helps physicians better visualize the heart and its structures. Cardiac catheterizations are only rarely performed to detect VSDs.
Researchers are testing a new diagnostic tool, a combination of an MRI (magnetic resonance imaging) and x-ray, called XMR. This measures blood flow and heart structure and function in three-dimensional imaging.
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