FETAL ECHOCARDIOGRAPHY - RM Solutions

FETAL
ECHOCARDIOGRAPHY
DR. SAUD ALOUFI
KING FAISAL HEART INSTITUTE

DORV

DORV

DORV

4 chambers

4 chamber

3 vessels

LVOT and RVOT

Short axis

What is wrong

What is wrong

d
a
P
A
C
svc

LV
RV
LA
A

RV
PA
LV

Aortic arch

Aortic arch

What is wrong

IVC

Fetal Circulation

RV
LV
RA
LA
RV
LV
A
P

Determine the right and left
J Am Soc Echo 1994;7:47-53

Determine the fetal cardiac
position and axis
Normal axis 45-65 degrees

BASIC VIEWS

SVC
Aa
SVC
A
P
a
SVC
P
A
a

RV
LV
A
LA
LV
RV
PA

HOW TO OBTAIN

P
ivc
V
a
a
a
Upper abdomen 4-chamber view 3-vessel view Short-axis view
LV
RV
LA
A
LV
RV
P
a
LVOT view RVOT view Aortic arch view

4 chambers

SVC
Aa
SVC
A
P
a
SVC
P
A
a

3 vessels view

Liver
Left
shoulder

Ductal arch

SVC IVC and arch

CHECKLIST OF IMPORTANT
STRUCTURES TO LOOK AT

P
ivc
V
a
a
a
Upper abdomen 4-chamber view 3-vessel view Short-axis view
LV
RV
LA
A
LV
RV
P
a
LVOT view RVOT view Aortic arch view

UPPER ABDOMEN TRANSVERSE VIEW
Liver
Stomach
Aorta
IVC

FOUR-CHAMBER VIEW
Cardiac position,
axis and size
Symmetry of
chamber size
AV valves and
moderator band
Pulmonary veins
Septal integrity
Function

THREE-VESSEL VIEW
Vessel number,
arrangement and size
Aortic and ductal arches
Trachea / bronchi
Branch pulmonary arteries

4 chambers sweep

LEFT AND RIGHT
VENTRICULAR
OUTFLOW TRACT
VIEWS
Crossing nature
and patency of the
outflow tracts
Septal integrity

BASAL SHORT AXIS
VIEW
Subpulmonary
outflow tract
Outlet septum

AORTIC AND DUCTAL
ARCH VIEWS
Shape, size and
narrowing of the aortic
and ductal arches
Head and neck
branches of the aortic
arch
Flow direction

Clues to abnormality

What is wrong

v
A
P
P
RA
LV
RV
Complete Transposition of the Great Arteries

Lt
P
A
v
P
S
Rt

v
A
P
P
RA
LV
RV
Tetralogy of Fallot

Determine the situs

What is wrong

RV
RV
RA
LV
LV
Rt
LA
Lt
LA
A
a
S

What is wrong

P
ivc
V
a
a
a
Upper abdomen 4-chamber view 3-vessel view Short-axis view
LV
RV
LA
A
LV
RV
P
a
LVOT view RVOT view Aortic arch view