Fetal heart/chest pathology registry review

Question 1

Hypoplastic left heart

Answer 1

Small or absent left ventricle. Surgery must be preformed within 1st month of life

Question 2

Leading cause of cardiac death in neonate

Answer 2

Hypoplastic left heart

Question 3

Cardiac view of hypoplastic left heart and possible causes

Answer 3

-4CH with small or absent left ventricle
- Aortic atresia, aortic stenosis, coarctation
-Connection with T13

Question 4

Hypoplastic right heart

Answer 4

Small or absent right ventricle

Question 5

Cause of hypoplastic right heart

Answer 5

Pulmonary stenosis or tricuspid atresia

Question 6

Cardiac view of hypoplastic right heart and additional findings

Answer 6

-Small/absent right ventricle, enlarged left ventricle
-Fetal hydrops

Question 7

Hydrops fetalis

Answer 7

Accumulation of fluid in 2 fetal body cavities

Question 8

Cause of hydrops fetalis

Answer 8

Heart failure, tumors, syndromes, ect

Question 9

Ventricular septal defects (VSD)

Answer 9

Opening or hole in ventricular septum; may be isolated or associated with other defects

Question 10

Most common cardiac defect

Answer 10

Ventricular septal defect

Question 11

Cardiac view of ventricular septal defects

Answer 11

4CH with beam perpendicular to IVS, showing “gap” with color flow crossing the septum

Question 12

Arterial septal defects (ASD)

Answer 12

Absence of segment of atrial septum (*foramen ovale should normally be seen as a large opening in septum)

Question 13

Atrioventricular septal defects
(endocardial cushion defect or AV canal defect)

Answer 13

Lack of development of central part of heart
Associated with T21

Question 14

Endocardial cushion

Answer 14

Where the IVS, IAS, septal valve leaflets connect at the center

Question 15

Cardiac view of atrioventricular septal defects

Answer 15

4CH absence of atrial/ventricular septum. Lack of apical offset to mitral valve and tricuspid valve

Question 16

Ebstein Anomaly

Answer 16

Tricuspid valve is incorrectly positioned apically within the right ventricles, atrialized right ventricle, poor prognosis

Question 17

Atrialized

Answer 17

A condition where part of the right ventricle becomes functionally part of the right atrium

Question 18

Cardiac view of ebstein anomaly

Answer 18

4CH malpositioned tricuspid valve, tricuspid regurfitation, enlarged right atrium

Question 19

Tetralogy of Fallot

Answer 19

Combination of 4 findings: overriding aorta, VSD, pulmonary stenosis, RV hypertrophy

Question 20

Cardiac vies of tetralogy of fallot

Answer 20

4CH and outflow tracts

Question 21

Rhabdomyoma

Answer 21

Echogenic tumors within myocardium; associated with tuberous sclerosis, cardiac failure, fetal hydrops

Question 22

Most common fetal cardiac tumor

Answer 22

Rhabdomyoma

Question 23

Tuberous sclerosis

Answer 23

Tumors on multiple organs

Question 24

Echogenic intracardiac focus (EIF)

Answer 24

Calcification of papillary muscle or chordae tendonae usually seen in left ventricle

Question 25

Ectopia Cordis

Answer 25

Heart located outside the chest through defect in sternum; elevated AFP

Question 26

Transposition of great vessels

Answer 26

Great vessels aorta and main pulmonary artery are switched
-Aorta rises from right ventricle
-Main pulmonary artery arises from left ventricle

Question 27

Coarctation of aorta

Answer 27

Narrowing of aortic arch, commonly between left subclavian artery and ductus arteriosus

Question 28

Associated findings with coarctation of aorta

Answer 28

Right ventricle and main pulmonary artery enlargement

Question 29

Cardiac views of coarctation of aorta

Answer 29

Outflow tracts, sagittal aortic arch, possibly normal 4CH

Question 30

Pericardial effusion

Answer 30

Fluid located AROUND the heart

Question 31

Pleural effusion

Answer 31

Fluid surrounding lungs
*bat wing sign = bilateral effusion

Question 32

Pulmonary hypoplasia

Answer 32

Underdevelopment of lungs
*result of other defects

Question 33

Most common cause of chest mass causing pulmonary hypoplasia / reason for cardiac malposition

Answer 33

Diaphragmatic hernia

Question 34

Diaphragmatic hernia

Answer 34

A birth defect in which there is an abnormal opening in the diaphragm

Question 35

Bochdalek hernia

Answer 35

Most common on left side; containing stomach, bowel and left lobe of liver
-No stomach will be seen in the abdomen
-Heart pushed to the right, stomach lateral to heart

Question 36

Right diaphragmatic hernia

Answer 36

Through foramen of Morgagni may allow entire liver into chest. -Heart pushed to left

Question 37

Congenital pulmonary airway malformation (CCAM)

Answer 37

Mass consisting of abnormal bronchial and lung tissue. Causes displacement of heart to contralateral side
-Normally regress spontaneously
-Large can lead to hydrops or pulmonary hypoplasia

Question 38

Type 1 congenital pulmonary airway malformation

Answer 38

Most common type. Macrocystic, large visualized cysts

Question 39

Type 2 congenital pulmonary airway malformation

Answer 39

Mixed, cystic and solid appearing

Question 40

Type 3 congenital pulmonary airway malformation

Answer 40

Microcystic. Cysts too small to be visualized, entire mass is echogenic. Similar appearance as pulmonary sequestration

Question 41

Pulmonary sequestration

Answer 41

Echogenic mass of nonfunctioning lung tissue with own blood supply or arises from thoracic aorta