How Are Holes in the Heart Diagnosed?

Holes in the heart are usually diagnosed based on results from a physical exam and special tests. The exam findings for an atrial septal defect (ASD) often aren't obvious, so the diagnosis is sometimes not made until later childhood or even adulthood. A ventricular septal defect (VSD) has a very distinct heart murmur, so this diagnosis is usually made in infancy.

Specialists Involved

Doctors who specialize in heart problems are called cardiologists. Pediatric cardiologists take care of babies and children who have heart problems. Other specialists who treat heart defects include cardiac surgeons (doctors who repair heart defects using surgery).

Physical Exam

During a physical exam, the doctor:

• Listens to your child's heart and lungs with a stethoscope
• Looks for signs of a heart defect, such as a heart murmur or signs of heart failure

Diagnostic Tests and Procedures

The doctor will order several tests to diagnose an ASD or VSD. These tests also will help the doctor determine the location and size of the defect.

Echocardiography

This test, which is harmless and painless, uses sound waves to create a moving picture of the heart. During echocardiography, ultrasound waves bounce off the structures of the heart, and then a computer converts them into pictures on a video screen. The test allows the doctor to clearly see any problem with the way the heart is formed or the way it's working.

Echocardiography is an important test for diagnosing a hole in the heart and for following the problem over time. This test shows problems with the heart's structure and how the heart is reacting to these problems. Echocardiography helps the cardiologist decide whether and when treatment is needed.

EKG

An EKG (electrocardiogram) detects and records the electrical activity of the heart. This simple and painless test is used to assess the heart rhythm. An EKG shows how fast the heart is beating and whether the heart's rhythm is steady or irregular. It also can detect enlargement of one of the heart's chambers, which can help to diagnose a heart defect.

Chest X Ray

A chest x ray takes a picture of the heart and lungs. It can show whether the heart is enlarged or whether the lungs have extra blood flow or extra fluid, which can be a sign of heart failure.

Pulse Oximetry

Pulse oximetry shows how much oxygen is in the blood. A sensor is placed on the fingertip or toe (like an adhesive bandage). The sensor is attached to a small computer unit, which displays a number that indicates how much oxygen is in the blood.

Cardiac Catheterization

During cardiac catheterization (KATH-e-ter-i-ZA-shun), a thin, flexible tube called a catheter is put into a vein in the arm, groin (upper thigh), or neck and threaded to the heart. A dye that can be seen on an x ray is injected through the catheter into a blood vessel or a chamber of the heart. This allows the doctor to see the flow of blood through the heart and blood vessels on the x-ray image.

Cardiac catheterization also can be used to measure the pressure inside the heart chambers and blood vessels and can determine whether blood is mixing between the two sides of the heart. It's also used to repair some heart defects. (See “How Are Holes in the Heart Treated?”)