How Are Holes in the Heart Diagnosed?

Doctors usually diagnose holes in the heart based on results from a physical exam and tests and procedures. The exam findings for an atrial septal defect (ASD) often aren't obvious, so the diagnosis sometimes isn't made until later childhood or even adulthood.

Ventricular septal defects (VSDs) have a very distinct heart murmur, so a diagnosis usually is made in infancy.

Specialists Involved

Doctors who specialize in diagnosing and treating heart problems are called cardiologists. Pediatric cardiologists take care of babies and children who have heart problems. Cardiac surgeons repair heart defects using surgery.

Physical Exam

During a physical exam, your child's doctor will listen to your child's heart and lungs with a stethoscope. The doctor also will look for signs of a heart defect, such as a heart murmur or signs of heart failure.

Diagnostic Tests and Procedures

Your child's doctor may recommend several tests to diagnose an ASD or VSD. These tests also will help the doctor determine the location and size of the defect.

Echocardiography

Echocardiography (echo) is a painless test that uses sound waves to create a moving picture of the heart. During the test, the sound waves (called ultrasound) bounce off the structures of the heart. A computer converts the sound waves into pictures on a screen.

Echo allows the doctor to clearly see any problem with the way the heart is formed or the way it's working.

Echo is an important test for both diagnosing a hole in the heart and following the problem over time. Echo can show problems with the heart's structure and how the heart is reacting to the problems. Echo will help your child's cardiologist decide whether and when treatment is needed.

EKG

An EKG is a simple, painless test that records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). It also records the strength and timing of electrical signals as they pass through each part of the heart.

An EKG can detect whether one of the heart's chambers is enlarged, which can help diagnose a heart problem.

Chest X Ray

A chest x ray is a painless test that creates pictures of the structures in the chest, such as the heart and lungs. This test can show whether the heart is enlarged or whether the lungs have extra blood flow or extra fluid, a sign of heart failure.

Pulse Oximetry

Pulse oximetry shows how much oxygen is in the blood. For this test, a small sensor is attached to a finger or toe (like an adhesive bandage). The sensor gives an estimate of 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.

Special dye is injected through the catheter into a blood vessel or a chamber of the heart. The dye allows the doctor to see the flow of blood through the heart and blood vessels on an x-ray image.

The doctor also can use cardiac catheterization to measure the pressure inside the heart chambers and blood vessels. This can help the doctor determine whether blood is mixing between the two sides of the heart.

Cardiac catheterization also is used to repair some heart defects. For more information, go to "How Are Holes in the Heart Treated?"