Study sets, textbooks, questions
Upgrade to remove ads
Terms in this set (73)
NORMAL CARDIAC AXIS
25 TO 65 DEGREES
0.45 at 17 WEEKS
0.5 at TERM
SITUS SOLITUS /LEVOCARDIA
NORMAL DEVELOPMENT AND POSITIONING OF ABDOMINAL AND THORACIC ORGANS IS REFERRED TO AS SITUS SILITUS FOR VISERAL ARRANGEMENT AND LEVOCARDIA FOR THORACIC ARRANGEMENT
morphologic right atrium
major hepatic lobe
morphologic left atrium
MIRROR IMMAGE ARRANGEMENT OF VESSELS AND ORGANS IN THE BODY
SLIGHT INCREASE IN CHD
KARTAGENERS SYND 20%
REFERS TO ABNORMAL ORGAN ARRANGEMENT AND POSITIONING
-irregular arrangement of non paired solitary abdominal organs
-symmetric arrangement of otherwise assymetric thoracic stucture( atria and lungs)
maternal risk factors for CHD
CARDIAC ANOMALIES MOST LIKELY TO BE ASSOCIATED WITH ANEUPLOIDY
CARDIAC ANOMALIES LEAST LIKELY TO BE ASSOCIATED WITH ANEUPLOIDY
TGA , HETEROTAXY SYNDROMES
INCIDENCE OF CHD IN VARIOUS ANEUPLOIDIES
TURNERS - 25 to 35%
TRISOMY 21- 40 to 50 %
TRISOMY 13 and 18 - 80%
cardiac anomalies associated with normal four chamber view 0f the heart
COMMON ARTERIAL TRUNK
CARDIAC ANOMALIES ASSOCIATED WITH ABNORMAL FOUR CHAMBER VIEW OF THE HEART
SEVERE AORTIC /PUL STENOSIS
CAUSES FOR FETAL CARDIOMEGALY
-tricuspid valve dysplasias
-premature constriction of DA
-AV Malformations (sacrococcygeal teratoma , vein of galen aneurysm , placental chorioangioma)
-RECIPIENT IN TTTS
-SEVERE FETAL ANEMIA
ANATOMICAL CHARACTERISTICS OF RIGHT ATRIUM
ANTERIORLY LOCATED TO THE RIGHT OF LEFT ATRIUM
RECIEVES IVC,SVC,CORONARY SINUS
CONTAINS SA &AV NODES
RIGHT ATRIAL APPENDAGE IS PYRAMIDAL IN SHAPE WITH BROAD BASE
ANATOMICAL CHARACTERISTICS OF RV
MOST ANTERIOR CHAMBER LOCATED BELOW STERNUM
APICAL REGION IS TRABECULATED
MODERATER BAND NEAR APEX
TRICUSPID AV VALVE
TRICUSPID VALVE MORE APICALLY INSERTED IN SEPTUM THAN MITRAL VALVE
CHORDAE TENDINEAE ATTACHED TO RV WALL AT THE APEX
ANATOMICAL CHARACTERISTICS OF LA
POSTERIORLY LOCATED OVER THE SPINE
RECEIVES FOUR PUL VEINS
LAFT ATRIAL APPENDAGE IS NARROW AND FINGER LIKE
ANATOMICAL CHARACTERISTICS OF LV
POSTERIOR AND TO THE LEFT
CONICAL IN SHAPE
BICUSPID MITRAL VALVE
TWO PAPILLARY MUSCLES THAT INSERT INTO FREE VENTRICULAR WALL
NORMAL FOUR CHAMBER VIEW
represents the inlet of the heart
transverse plane of fetal chest with one complete rib on each side of chest wall
--size and location of heart (2/3 in left hemithorax)
-apex pointing to left with an axis of 45 degree
-descending aorta in front and left of spine
-atria equal in size
-foramen ovale in mid atrial septum
-flap valve in LA
-Pul veins draining into LA
-two separate av valves with offset appearance
-ventricles equal in size and contractility
-Moderator band in RV
-apex formed by LV
-intact ventricular septum
COMMON ARTERIAL TRUNK
-single arterial trunk from base of the heart which
-supplies coronary pulmonary and systemic circulations.
-malaligned VSD always present
-truncal valve is comitted to both ventricles
-4types based on origin of pul artery
4 chamber view - normal
3VV -a single trunk f life
lv long axis view - malaligned vsd
and pulmonary arteries arising from the single trunk
-22q11 microldelation reported in 40%of cases(karyotyping)
-surgical repair 2 to 3 months of life.
-depends on extracardiac & chromosomal anomalies
pulmonary atresia with vsd
pulmonary atresia with vsd
pul trunk is usually absent
-pul branches dependent on ductus arteriosus or MAPCAS(Major aortopulmonary collateral arteries
-extreme form of TOF
long axis view of LV shows malaligned VSD
confluent left and right pulmonary arteries (sea gull appearance)
overiding of aorta
retrograde flow in ductus arteriosus
MAPCAS branching off from descending aorta)
Apical five chamber view is useful in assessing...................................
the septoaortic continuity
VSD, overriding AO, pulm sten/ao, rt vent hypertrophy, increased NT 1st tri, increased velocity in pulm art
25% will have rt sided arch,
4 ch V-NORMAL
5 chamber view - ao override
3vv - rt side arch&small pulm art
Three vessel trachea view
aortic and ductal arch merge at the descending aorta
transverse aortic arch
comparison of vessel size
number of vessels
blood flow direction
location of both great vessels to the left of trachea
axial view of upper mediastinum
abnormalities of great vessels.aortic arch and thymus can be diagnosed
abnormalities may involve
-size of vessels
-location of descending aorta
largest and most anterior and to the left is pul artery
svc is the smallest
trachea is not seen in this plane
persistent left svc
-results from failure of the left anterior and common cardinal veins to involute.
-LSVC joins the coronary sinus and drains into the right atrium in 92% of cases or into the left atrium in the remainder of cases.
-Identifying LSVC can be achieved in four transverse planes and in one longitudinal plane;
a plane just posterior to 4-ch view,
left brachiocephalic view, and
a left parasagittal view.
-Increased NT has been shown in 29% of fetuses with LSVC.
-Heterotaxy accounts for the most common associated cardiac malformation with LSVC.
-VSDs and coarctation of aorta were among the most common associated cardiac malformations in nonheterotaxy group with LSVC.
-Chromosomal anomalies were reported in 9% of LSVC in one study.
-Isolated LSVC does not seem to be associated with clinical problems postnatally
types of anomalous pathways of pulmonary veins
TYPE 1 (SUPRACARDIAC)- most common
4 PVs (Merge into a confluence and drain into) >VERTICAL VEIN>INNOMINATE VEIN >SVC
PV>CORONARY SINUS>RIGHT ATRIUM
PV>POSTERIOR WALL OF RIGHT ATRIUM
TYPE 111 (INFRACARDIAC)
4PVs (connected to anomaolous descending vein which accompanies esophagus crosses diaphragm and drains into)>PORTAL VEIN>DUCTUS VENOSUS > IVC
( worst prognosis than the other types as it is associated with pulmonary venous obctruction)
TYPE 1V - MIXED TYPE
TAPR IS ASSOCIATED WITH ................................
AVSDs, HETEROTAXY SYNDROMES(right atrial isomerism)
ASD (sinous venousus type)
OFTEN THE FIRST SIGN OF APVR IS
MILD RV & PA PROMINENCE
USG FEATURES OF TAPVR
4 CH VIEW-
NO PULMONARY VEINS ENTERING LA
MILD RA RV PROMINENCE
SMALL LA (due to decreased blood return)
BULGING OF INTER ATRIAL SEPTUM INTO LA
VENOUS CONFLUENCE BEHIND LA
4th VESSEL SEEN WHICH IS THE VERTICAL VEIN(same anatomical location as persistent left SVC)
DILATED INNOMINATE VEIN
1,2 OR 3 PVs entering RA
difficult to diagnose antenatally
PAPVR may be associated with
RT LUNG HYPOPLASIA
HYPOPLASIA OF RIGHT PULMONARY ARTERY
RIGHT INFERIOR PULMONARY VEIN DRAINS INTO IVC (PAPVR)
cardiac anomalies associated with heart block
left atrial isomerism
CAUSES OF HEART BLOCK IN A FETUS
40% STRUCTURAL DISEASE
60% ASSOCIATED WITH CONNECTIVE TISSUE DISEASE
FETAL BRADYCARDIA IS HEART RATE LESS THAN
causes of fetal bradycardia
blocked atrial bigeminy/trigeminy
high degree av block
most common irregular cardiac rhythm is
most comon cause of fetal tachycardia
1:1 RATIO OF AV CONDUCTION
ACCESSORY PATHWAY CAUSING RETROGRADE ENTRY
CAUSES OF SINUS TACHYCARDIA
MAIN PUL. ARTERY WITH DES. AORTA
DA CONSTRICTION IS CAUSED BY MATERNAL DRUG THERAPY WITH ....................
PROSTOGLANDIN SYNTHETASE INHIBITORS (INDOMETHACIN)
FACTORS INFLUENCING DA CONSTRICTION DUE TO INDOMETHACIN
DURATION OF THERAPY
GESTATIONAL AGE AT TREATMENT
( shpould not be used after 32 weeks)
usg features of ductal constriction
4 ch view
-dilated, hypokinetic RV
psv in ductus -200 to 300cm/sec
high diastolic velocities with P<,1.9
effect of interruption of indomethacin .
reverses the constriction
double vessel sign
Interrupted IVC with azygous continuation
Which of the following is associated w/ 22q11 deletion: mitral stenosis,
persistent left SVC,
Which of the following would be indicative of Tricuspid insufficiency?
retrograde flow in early diastole,
holosystolic flow in diastole,
retrograde flow in early systole,
holosystolic flow in systole
holosystolic flow in systole
The normal direction of bf through FO is?
from Right Atrium to Left Atrium
All of the following are indications for an echo except? Lupus,
The most appropriate view to interrogate to interventricular septum is the?
Subcostal 4 chamber view
All of the following are signs of coarc of the AO EXCEPT?
enlarged right ventricle,
enlarged left ventricle,
increased velocities int he AO,
a narrowing of the AO
enlarged left ventricle
Which of the following is most commonly seen in a fetus of a diabetic mother? dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, congestive cardiomyopathy
What are the 3 fetal cardiac shunts?
Ductus Venosus, Ductus Arteriosus, Foramen Ovale
Which system is the first to function in the embryo?
the initial step in any fetal echocardiogram exam is to?
establish fetal position
What cardiac defects are associated with maternal diabetes?
cardiomyopathy with thickening of cardiac walls and transposition of great arteries
Coartation of the AO is seen with what syndrome?
Name 6 things to check in the 3VT view
1. Course & Size of --PA, Ao, SVC
2. Ao isthmus and DA;
3 Ao is right or left side of the trachea
5. assessment by color Doppler (blue or red V)
6.Additional vessels (left persistent SVC or abnormal vertical vein located to the left of PA
internal mammary arteries form the lateral borders of thymus gland
Maternal Lupus increased risk of
complete heart block
The most common cardiovascular abnormality associated with Rubella is
he most common cardiovascular abnormality associated with Noonan's syndrome
Pulmonic valvular stenosis (50% of fetuses)
What is the most common location of coarctation? (90%)
between the origin of the left subclavian artery and the ductus arteriosus?
What shape are doppler waveforms across the atrioventricular valves?
What shape is the waveform for the IVC?
The ___ ___ Doppler waveforms are similar to those in the ductus venosus with a triphasic shape.
Simple cause of bradycardia?
What is the most common ASD?
In what view are ASDs best seen?
A VSD that presents with multiple interventricular communications between the ventricles
Swiss cheese defect"
(trabecular or apical)
What is the preferred method to asses vavlular regurgitation?
Sets found in the same folder
Gallbladder Pathology Ultrasound Images
Fetal Heart Anatomy
Development of the heart
Sets with similar terms
Ch. 33 & 34 - fetal echocardiography - 02/19/18 -…
Fundamentals - Echo
The echocardiography examination test 2
OB/GYN Fetal Heart
Other sets by this creator