Limitation of 2 dimensional color Doppler echocardiography in the diagnosis of congenital heart disease.

To assess the limitations of 2 Dimensional Color Doppler Echocardiography in the evaluation of cardiac anatomy in children with congenital heart disease. 2DCDE were performed in 140 infants and children before cardiac catheterization and/or operation or autopsy. The segmental echocardiographic analysis included determination of intracardiac, great artery, systemic venous and pulmonary venous anatomy. Among 140 patients there were 270 separate cardiovascular abnormalities of which 215 (80%) were identified by 2D echo. There were 55 (20%) false negative diagnosis by 2DE. Small VSD, unusual location of PDA, stenosis of pulmonary arterial and venous system, intra pulmonary arterio-venous fistula and pseudotruncus were the lesions most likely to be misdiagnosed by 2DE. Color Doppler was useful to detect abnormal flow of valvular regurgitation or left to right shunt. Doppler is useful to detect abnormal flow from obstruction or regurgitation or left to right shunt and may be used to predict the pressure in the chambers of the heart and great artery. General limitation of 2DCDE to diagnose CHD include; obesity and emphysematous child, some inherent limitation in each instrument and also inexperienced echocardiographer.