Fetal heart/chest pathology registry review Flashcards
Hypoplastic left heart
Small or absent left ventricle. Surgery must be preformed within 1st month of life
Leading cause of cardiac death in neonate
Hypoplastic left heart
Cardiac view of hypoplastic left heart and possible causes
-4CH with small or absent left ventricle
- Aortic atresia, aortic stenosis, coarctation
-Connection with T13
Hypoplastic right heart
Small or absent right ventricle
Cause of hypoplastic right heart
Pulmonary stenosis or tricuspid atresia
Cardiac view of hypoplastic right heart and additional findings
-Small/absent right ventricle, enlarged left ventricle
-Fetal hydrops
Hydrops fetalis
Accumulation of fluid in 2 fetal body cavities
Cause of hydrops fetalis
Heart failure, tumors, syndromes, ect
Ventricular septal defects (VSD)
Opening or hole in ventricular septum; may be isolated or associated with other defects
Most common cardiac defect
Ventricular septal defect
Cardiac view of ventricular septal defects
4CH with beam perpendicular to IVS, showing “gap” with color flow crossing the septum
Arterial septal defects (ASD)
Absence of segment of atrial septum (*foramen ovale should normally be seen as a large opening in septum)
Atrioventricular septal defects
(endocardial cushion defect or AV canal defect)
Lack of development of central part of heart
Associated with T21
Endocardial cushion
Where the IVS, IAS, septal valve leaflets connect at the center
Cardiac view of atrioventricular septal defects
4CH absence of atrial/ventricular septum. Lack of apical offset to mitral valve and tricuspid valve
Ebstein Anomaly
Tricuspid valve is incorrectly positioned apically within the right ventricles, atrialized right ventricle, poor prognosis
Atrialized
A condition where part of the right ventricle becomes functionally part of the right atrium
Cardiac view of ebstein anomaly
4CH malpositioned tricuspid valve, tricuspid regurfitation, enlarged right atrium
Tetralogy of Fallot
Combination of 4 findings: overriding aorta, VSD, pulmonary stenosis, RV hypertrophy
Cardiac vies of tetralogy of fallot
4CH and outflow tracts
Rhabdomyoma
Echogenic tumors within myocardium; associated with tuberous sclerosis, cardiac failure, fetal hydrops
Most common fetal cardiac tumor
Rhabdomyoma
Tuberous sclerosis
Tumors on multiple organs
Echogenic intracardiac focus (EIF)
Calcification of papillary muscle or chordae tendonae usually seen in left ventricle
Ectopia Cordis
Heart located outside the chest through defect in sternum; elevated AFP
Transposition of great vessels
Great vessels aorta and main pulmonary artery are switched
-Aorta rises from right ventricle
-Main pulmonary artery arises from left ventricle
Coarctation of aorta
Narrowing of aortic arch, commonly between left subclavian artery and ductus arteriosus
Associated findings with coarctation of aorta
Right ventricle and main pulmonary artery enlargement
Cardiac views of coarctation of aorta
Outflow tracts, sagittal aortic arch, possibly normal 4CH
Pericardial effusion
Fluid located AROUND the heart
Pleural effusion
Fluid surrounding lungs
*bat wing sign = bilateral effusion
Pulmonary hypoplasia
Underdevelopment of lungs
*result of other defects
Most common cause of chest mass causing pulmonary hypoplasia / reason for cardiac malposition
Diaphragmatic hernia
Diaphragmatic hernia
A birth defect in which there is an abnormal opening in the diaphragm
Bochdalek hernia
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
Right diaphragmatic hernia
Through foramen of Morgagni may allow entire liver into chest. -Heart pushed to left
Congenital pulmonary airway malformation (CCAM)
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
Type 1 congenital pulmonary airway malformation
Most common type. Macrocystic, large visualized cysts
Type 2 congenital pulmonary airway malformation
Mixed, cystic and solid appearing
Type 3 congenital pulmonary airway malformation
Microcystic. Cysts too small to be visualized, entire mass is echogenic. Similar appearance as pulmonary sequestration
Pulmonary sequestration
Echogenic mass of nonfunctioning lung tissue with own blood supply or arises from thoracic aorta
