Case 3 — Doppler Echocardiogram

Color Flow Doppler

Color flow Doppler echocardiogram in systole (ECG cursor just after the QRS complex) showing a high-velocity turbulent jet originating at the interventricular septum near the aortic root and projecting into the right ventricular cavity, consistent with a left-to-right ventricular septal defect shunt

Continuous Wave Spectral Doppler

Continuous wave Doppler spectral tracing across the ventricular septal defect showing a peak systolic velocity of 4.81 meters per second, corresponding to a pressure gradient of approximately 92 mmHg between the left and right ventricles by the modified Bernoulli equation

The color flow Doppler (first picture) shows a high-velocity systolic jet (note that the cursor on the ECG is right after the QRS complex) that originates at the same region as the arrow on the two-dimensional echocardiogram shown previously. The jet projects into the right ventricular cavity. The continuous wave Doppler measures the peak velocity of this jet to be 4.81 meters/second. This translates into a pressure gradient across this region of 92 mmHg. The color flow Doppler confirms the anatomic diagnosis and the continuous wave Doppler provides a measure of the severity of the lesion (small, medium, or large).

Color flow Doppler echocardiogram from a different dog with the same abnormality as Wolfie

Quiz

1. The pressure gradient between the left and right ventricles suggests that the lesion severity is:

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