Abnormal fetal heart

How can things appear in fetal heart defects ?

to small

misplaced

missing or closed

side effect: enlarged

Hypoplastic left heart

small or absent LV

Causes of hypoplastic left heart

Aortic atresia

Aortic stenosis

Coarctation

Cardiac view of hypoplastic left heart

4CH-

small/absent LV

What is the leading cause of death in the neonate

Hypoplastic left heart

Hypoplastic right heart

small or absent RV

Causes of hypoplastic right heart

Pulmonary stenosis

Tricuspid atreisa

Fetal hydrops

accumulation of fluid in two fetal body cavities

Cardiac view of hypoplastic right heart

4CH

enlarged LV

small/ absent RV

Ventricular septal defect VSD

opening in the ventricular septum

what is associated with VSD ?

Trisomy 21

tetralogy of fallot

Cardiac view of VSD

4CH with beam perpendicular to septum

Shows gap with color flow crossing septum

Most common cardiac defect

Ventricular septal defects

Atrial septal defect ASD

Missing part of the atrial septum

Atrioventricular septal defect AVSD

Lack of central heart development

Other names for AVSD

AV canal defect

Endocardial cushion defect

Cardiac view of AVSD

4CH- absence of atrial/ ventricular septum

lack of apical offset of MV, TV

what is associated with AVSD

Trisomy 21

Ebstein anomaly

Tricuspid valve is incorrectly positioned within RV

What is associated with ebstein’s anomaly

fetal hydrops

tetralogy of fallot

tricuspid regurgitation

coarctation

transposition of great vessels

Cardiac view of Ebstein’s anomaly

4CH- malpositioned TV and poor tricuspid regurgitation

enlarged RV

Tetralogy of fallot

Combo of 4 things:

Overriding aorta

VSD

Pulmonary stenosis

RV hypertrophy

Cardiac view of tetralogy of fallot

Abnormal 4CH and outflow tracts

Rhabdomyoma

Echogenic tumor within myocardium

what is associated with rhabdomyoma

fetal hydrops

Tuberous sclerosis

Most common fetal cardiac tumor

rhabdomyoma

Echogenic Interface Focus ELF

Calcification of papillary muscle usually seen in LV

Ectopia Cordis

Heart located outside the chest through septum defect

What is associated with ectopia cordis?

elevated AFP

pentalogy of cantrell

Transposition of great vessels

Aorta and MPA are switched

Cardiac view of transposition of great vessels

4CH may be normal

Abnormal outflow tract views

Describe transposition of great vessels

Aorta arises from RV and MPA from LV

Coarctation of Aorta

Narrowing of aortic arch

Where is Coarctation of Aorta commonly seen?

between Lt subclavian artery and ductus arteriosus

Cardiac view of Coarctation of Aorta

4CH normal

abnormal sag aortic arch, outflow tracts

Pericardial effusion

Fluid around the heart

Pleural effusion

Fluid around the lungs

Pulmonary hypoplasia

Underdevelopment of the lungs

Pulmonary hypoplasia is a result of what other defects ?

chest masses

oligohydramnios

skeletal deformities

Diaphragmatic hernia is the most common ……

chest mass

reason for cardiac malpositioning

chest mass causing pulmonary hypoplasia

Describe a diaphragmatic hernia on the right side of the chest

Hernia is pushed through the foramen morgagni allowing the liver into the chest cavity

Heart is pushed to the left

Other name for diaphragmatic hernia on the left side of the chest

Bochdalek hernia

Describe a diaphragmatic hernia on the left side of the chest

Herniation of the stomach, bowel, left liver lobe

stomach now is seen in the chest cavity pushing the heart to the right

Congenital pulmonary airway malformation CPAM

mass consisting of abnormal bronchial/ lung tissue

develops into cysts

Type 1 CPAM

Macrocystic

large visualized cyst

Type 2 CPAM

a mix of cystic and solid appearance

micro/macro mix

Type 3 CPAM

Microcystic, cysts are too small to be seen

entire mass is echogenic

most common type of CPAM

Type 3

Pulmonary sequestration

Echogenic mass of nonfunctioning lung tissue with its own blood supply

Difference between CPAM vs. pulmonary sequestration

Vascularity of the independent blood supply from pulmonary sequestration