Post—Myocardial Infarction Ventricular Septal Defect

The case presented is that of a man in his late 60s who experienced an acute anterior myocardial infarction. A complete 2D echocardiogram with color flow and Doppler imaging had been performed on the patient's first hospital day. On day 2 of his hospitalization, a follow-up limited study was performed to reevaluate left ventricular function. Cardiac function was essentially unchanged from the prior day's study. However, color flow Doppler was performed, and a distal septal ventricular septal defect was detected incidentally, only in the final apical view while using the full-height color sector box. This study demonstrates the value of using the full-size color sector box as a screening tool when performing color flow Doppler. Current high-capacity (256 channel and above) equipment assists the sonographer with image optimization and decreases the need to use the truncated color flow box.