What is the role of echocardiography in the diagnosis and management of VSD in both children and adults?

Echocardiography plays a central role in both the diagnosis and management of ventricular septal defects (VSD) in children and adults. It is the primary non-invasive imaging modality used to confirm the presence, size, location, and haemodynamic significance of the defect, which is essential for clinical decision-making ¹.

In children, transthoracic echocardiography (TTE) with Doppler assessment is typically sufficient to identify the VSD, evaluate shunt direction and volume, and detect associated cardiac anomalies. This allows for timely diagnosis and monitoring of spontaneous closure or progression ¹ (Andrade, 1991). In adults, echocardiography remains crucial to assess residual defects, complications such as pulmonary hypertension, and ventricular function, which influence management strategies ¹ (Penny and Vick GW 3rd, 2011).

Doppler echocardiography specifically provides detailed haemodynamic information by measuring flow velocity across the septal defect, estimating pressure gradients, and quantifying shunt severity, which guides the need for intervention ¹ (Andrade, 1991). This is important in both paediatric and adult populations to determine the timing and type of treatment.

For management, echocardiography is indispensable in follow-up and procedural planning. It is used to monitor changes in defect size and cardiac function over time, and to evaluate suitability for percutaneous or perventricular device closure, which has become an increasingly preferred treatment option in selected cases ¹ (Lozier et al., 2023). Post-procedural echocardiography confirms device position, residual shunting, and complications.

Overall, echocardiography integrates anatomical and functional assessment, enabling tailored management of VSD across all ages, from initial diagnosis through to long-term follow-up and intervention planning ¹ (Andrade, 1991; Penny and Vick GW 3rd, 2011; Lozier et al., 2023).