[Doppler pulse and interventricular communication].

To test the diagnostic accuracy of pulsed Doppler and two-dimensional echocardiography (2D-echo) in ventricular septal defect (VSD), 32 children were studied. All were suspected on clinical grounds to have a VSD. In 17 children, the VSD was proven by cardiac catheterization (group I, mean age 10 years); in 15, only non-invasive investigation was carried out (group II, mean age 1 year). In group I, 2D-echo showed a ventricular septal defect in 14 cases (82%); the Doppler study demonstrated a typical systolic turbulent flow in the right ventricle, in front of the septum, in all cases. In group II, the VSD was visualized by 2D-echo in 11 cases (73%). Pulsed Doppler showed a typical turbulent flow in the right ventricle in all cases. Thus, pulsed Doppler appears more sensitive in detecting ventricular septal defect--especially of small size--than 2D-echo. The diagnostic value of Doppler remains intact when associated cardiac malformations are present and in cases of pulmonary hypertension, as long as the shunt is not reversed.