M-shaped doppler signal across ventricular septal defect: potential implications for estimation of right ventricuilar systolic pressure.

ABSTRACT

An 8-year-old child suffering from ventricular septal defect and severe valvular pulmonary stenosis was evaluated by echo-Doppler technique and cardiac catheterization. A peak instantaneous transventricular systolic gradient of 64 mmHg was recorded across the ventricular septal defect with an interesting M-shaped spectral pattern. However, cardiac catheterization revealed a peak-to-peak non-simultaneous gradient between the right and the left ventricle of only 14 mmHg. This discrepancy along with its implications are discussed in this report.