Detecting Heart Defects

A septal defect is an opening in the cardiac septum, the wall that separates the right and left sides of the heart. Normally, this structure prevents oxygen-rich and oxygen-poor blood from mixing. Through the opening, however, blood can pass from the left side of the heart to the right.

Doctors distinguish mainly between two forms: an atrial septal defect (ASD) between the atria and a ventricular septal defect (VSD) between the ventricles.

Small defects often cause no symptoms for a long time. Larger openings place greater strain on the right side of the heart and the lungs. Patients may experience reduced exercise capacity, shortness of breath or cardiac arrhythmias. Over the long term, increased pressure can also develop in the pulmonary vessels, placing persistent strain on the right side of the heart.

Tetralogy of Fallot is a congenital heart defect consisting of four characteristic changes: narrowing of the pulmonary artery, an opening in the cardiac septum, thickening of the muscle of the right ventricle and displacement of the aorta.

As a result of this combination, some oxygen-poor blood from the right side of the heart enters the systemic circulation directly. The body therefore receives less oxygen than usual.

Symptoms vary depending on severity. Many affected people develop reduced exercise capacity, shortness of breath or bluish discoloration of the lips and skin. Without treatment, the long-term strain can further weaken the heart.

In this congenital malformation, the two major vessels of the heart are reversed: the aorta arises from the right ventricle, while the pulmonary artery is connected to the left ventricle. As a result, oxygen-poor blood circulates through the body while oxygen-rich blood largely returns to the lungs.

Without treatment, the body does not receive enough oxygen. Affected people often have breathing problems, reduced exercise capacity and bluish discoloration of the lips or skin.

Coarctation of the aorta is a narrowing of the main artery, usually in the area just beyond the branches supplying the head and arms. This narrowing obstructs blood flow from the heart into the systemic circulation.

The heart therefore has to work harder to pump blood through the narrowed section. Blood pressure often rises in the upper part of the body, while the legs and lower body receive less blood. Over time, the additional strain can weaken the heart muscle.

Heart valves control blood flow through the heart and ensure that blood moves in only one direction. With congenital malformations, individual valves may not open fully or may not close properly.

If a valve is narrowed, the heart must generate more force to push blood through the opening. If a valve does not close sufficiently, some blood flows backward. Over time, this additional strain can impair heart function and cause symptoms such as reduced exercise capacity or cardiac arrhythmias.

Heart valves can wear over the course of life. In some cases, a valve becomes narrowed so that blood can pass through only with difficulty. This is referred to as valve stenosis.

In other cases, a valve no longer closes completely. Some of the blood then flows backward, which is referred to as valve insufficiency or regurgitation.

Both changes increase the workload on the heart. The heart muscle must work harder to maintain blood flow. Affected people often notice reduced exercise capacity, shortness of breath or cardiac arrhythmias.

After a heart attack, scar tissue can develop in the heart muscle. In these areas, the tissue loses some of its mobility and contributes less to the pumping movement of the heart.

The larger the affected area, the more the heart’s pumping capacity may decline. Patients may tire more quickly or become short of breath earlier during physical activity.

In cardiomyopathies, the heart muscle itself changes. It may thicken, enlarge or lose strength. As a result, the heart works less effectively and can no longer pump blood through the systemic circulation as reliably.

Depending on the form, affected people may develop reduced exercise capacity, shortness of breath or cardiac arrhythmias. In more pronounced cases, the heart’s pumping function may decrease significantly and heart failure can develop.

Infections can affect the heart valves or heart muscle. Such inflammation is often caused by bacteria or viruses.

Inflammation can impair valve function or the strength of the heart muscle. Patients may then develop cardiac arrhythmias, reduced exercise capacity or impaired pumping function.

During the examination, MRI uses a strong magnetic field and radio waves to create numerous cross-sectional images of your heart from different angles. An ECG synchronizes image acquisition with the heartbeat so that every phase of cardiac movement can be recorded. This allows the heart muscle, chambers, valves and major vessels to be visualized in great detail.

Additional measurement techniques also make it possible to analyze the direction and speed of blood flow within the heart and the major vessels.

Heart MRI at our radiological prevention center in Düsseldorf provides very detailed information about the structure and function of the heart. It is particularly suitable for visualizing congenital heart defects such as septal defects or complex malformations and assessing their effects on blood flow. Acquired changes in the heart valves, thickening or enlargement of the heart muscle and scar tissue after a heart attack can also be visualized reliably.

Special measurement techniques can additionally show blood flow between the heart chambers and major vessels.

Cardiac MRI not only makes changes in the heart visible, but also shows how they affect heart function. Abnormal movement of the heart muscle can be identified when individual sections of the heart wall contract less strongly than others. This allows us to assess exactly which areas of the heart muscle are working normally and where there may be limitations.

Changes in blood flow also become visible during the examination. Special measurement techniques show the direction and speed of blood within the heart and major vessels, allowing abnormal flow patterns to be assessed more precisely. Structural changes such as thickened heart walls, enlarged chambers or unusual connections between vessels can also be seen directly on the cross-sectional images.

This combination of detailed anatomy and functional analysis helps classify heart defects precisely and assess their effects on cardiac performance.