Pitfalls of Using VSD Doppler to Estimate Right Ventricular Systolic Pressure

• Jet angle may change with cardiac motion affecting the peak Doppler velocity.
• A small vsd jet may give a weak Doppler signal resulting in underestimation of the maximum velocity and consequently overestimating right ventricular systolic pressure.
• A muscular ventricular septal defect may have decreased flow in mid systole secondary to contraction of the interventricular septum affecting the Doppler signal.

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