The Correlation Between the Clinical and Echocardiographic Findings in Isolated Ventricular Septal Defect

Echocardiographic and clinical findings in 120 patinets with isolated VSD were evaluated in order to evaluate the relationship between them. In this series, perimembranous defects were most frequent (76 %), followed by subarterial and muscular defects. There was a good correlation between the size of the left ventricle and the size of the defect. Pulmonary hypertension of third degree occurred in large defects alone and did not accompany small defects. The correlation between the size of the VSD and cardiothoracic rato (CTR) was very significant (r=0.56, n= 113). CTR showed a specificity of 83 % and sensitivity of 62 % with respect to the size of the defect. The correlation between CTR and the echocardiographic size of the left ventricle was also very high. CTR showed a sensitivity of 66 % and a specificity of 81 % with the size of the left ventricle. Considered multifactorially CTR correlated best with both size of the defect and that at the left ventricle, (r=0.72, n=67). CTR showed a sensitivity of 85 % for patients with large defects as well as large left ventricle and a specificity of 93 % in patients with small defects and normal left ventricle. The quantity of echocardiographic left-to-right shunt disclosed a sensitivity of 76 % and a specificity of 73 % with the clinical estimate of it. The pattern of right ventricular hypertrophy in the ECG showed a sensitivity of 100 % and a specificity of 84 % in the setting of echocardiographically-estimated presence of pulmonary hypertension. It was concluded that, in view of its high sensitivity and specificity rates, the presented clinical hemodynamic classification in isolated VSD was adequate to justify its practical use.