Describe Components of a Complete Diagnosis of Congenital Heart Disease ?
A complete diagnosis of congenital heart disease requires accurate and thorough description of the heat and great vessels in a systematic fashion in addition to a detailed description of the anatomy and physiology of the basic defect(s). Today this is often achievable through systematic 2D and Doppler echocardiogsaphy again, a checklist of questions to be addressed is very useful.
1) What is the visceral and atrial situs (solitus, inversus or ambiguous)?
2) What are the systemic venous connections like? Is the IVC intact? Is there a separate LSVC? If so, how does it drain?
3) What is the relationship of the abdominal aorta to the IVC?
4) What is the appearance of the atria like? Is the atrial septum intact? Is there an ASD or a patent foramen ovale? If so, what direction does blood flow?
5) How do the atria connect to the ventricles (concordant or discordant)?
6) Is it possible to identify two separate AV valves?
7) How are the AV valves in their appearance and function?
8) The ventricles: their size shape and function?
9) Are the various components of the inteiventricular septum intact?
10) Is there any outflow tract obstruction?
11) How do the ventricles connect to the great arteries?
12) What is the appearance and function of the semilunar valves?
13) What is the great artery relationship?
14) Are the branch pulmonary arteries in continuity? Is there any branch pulmonary artery stenosis?
15) What side is the aortic arch? What is its branching pattern? Is there a PDA or a coarctation?
At any stage of the examination, if an abnormality is identified, the anatomy and physiology of the defect should be outlined as precisely as possible.