Obligatory medical device diagnostics.
- Electrocardiogram1-5 (ECG; recording of the electrical activity of the heart muscle).
- Echocardiography1-5 (echo; cardiac ultrasound) including color Doppler – for localization and quantification of valvular insufficiencies and stenosesSevere aortic stenosis according to ESC (European Society of Cardiology) and ACC/AHA (American College of Cardiology/American Heart Association).
- Vpeak ≥ 4 m/s,
- Mean pressure gradient (MG) ≥ 40 mmHg, and
- Flap opening area (KÖF) ≤ 1 cm2.
- X-ray of the thorax (X-ray thorax/chest)1+2, in two planes.
- Pulse oximetry screening (procedure that serves the continuous non-invasive measurement of oxygen saturation of arterial blood as well as pulse rate) (see below).
Optional medical device diagnostics – depending on the results of the medical history, physical examination, laboratory diagnostics and mandatory medical device diagnostics – for differential diagnostic clarification.
- Exercise ECG1+2 (electrocardiogram during exercise, that is, physical activity/exercise ergometry) [mitral regurgitation: P mitral; possible atrial fibrillation, left ventricular hypertrophy, possibly. Signs of right heart strain in advanced stages; aortic stenosis: signs of left heart hypertrophy (positive Skolow-Lyon index), ST-segment elevations, especially in leads I, V5, and V6 as an expression of ischemia; aortic regurgitation: accentuation of Q-spikes, signs of left heart hypertrophy].
- Cardiac catheterization
- Right heart catheterization1
- Left heart catheterization1+2+3+4+5
- Magnetic resonance imaging (MRI) of the heart (cardio-MRI).
- Cardio-CT (cardiac CT) – if echocardiography or cardio-MRI is limited assessable, cardio-CT is a good alternative for imaging the heart valves.
- Abdominal sonography (ultrasound examination of the abdominal organs).
1Mitral valve stenosis (mitral stenosis) 2Mitral valve insufficiency (mitral regurgitation) 3Mitral valve prolapse 4Aortic valve stenosis (aortic stenosis) 5Aortic valve insufficiency (aortic regurgitation).
Pulse Oximetry Screening
- Pulse oximetry screening for critical congenital heart defects has led to a significant decrease in infant mortality from heart defects in the United States. Common to these vitias is a shunt of unoxygenated blood in the great circulation associated with cyanosis. This is often overlooked in the newborn and detected by pulse oximetry. Subsequent Doppler sonography of the heart can then confirm or rule out the suspicion.According to the authors of this study, pulse oximetry screening resulted in an additional decrease of about one-third in deaths from critical heart defects in infancy. The absolute decrease was 3.9 deaths per 100,000 births.
