Sequential Segmental Analysis of Cardiac Morphology

Knowledge of the details of morphology is the cornerstone in understanding the aberration in hemodynamics observed in patients with congenital heart disease. As such, it is essential to establish the morphology of any patient with congenital heart disease prior to instituting a plan for management. A reasonably short list of differential diagnosis can be made through clinical assessment. Precise categorization of the defect itself, however, requires investigative studies such as echocardiography. Computed tomographic angiography and magnetic resonance imaging now play important roles in refining the diagnosis but rarely in the early stages of assessment. All these techniques, nonetheless, rely on trans-sectional imaging. The images, therefore, produced must be reconstructed, either mentally or through software, to produce three-dimensional images close to the true anatomy of the heart and the defects it contains. Examination of autopsied specimens and surgical observations provide clear understanding of the salient anatomy, albeit for obvious reasons not helpful for diagnostic purposes at the early stages of assessment.