Fetal intracardiac echogenic foci: visualization depends on the orientation of the 4-chamber view

To compare the frequency of visualization of echogenic intracardiac foci in different cardiac views.

Women having ultrasonographic examinations between October 1997 and July 1998 were prospectively evaluated if a fetal echogenic intracardiac focus was seen in either ventricle.

Echogenic intracardiac foci were seen in 89 fetuses in whom both the apical and lateral 4-chamber heart views were obtained. Eight-six fetuses (97%) had a single focus (83 in the left ventricle and 3 in the right ventricle), and 3 (3%) had 2 foci. Echogenic intracardiac foci were seen in the apical 4-chamber view in 89 (100%) and in the lateral 4-chamber view in only 26 (29%; P = .001).

Echogenic intracardiac foci are not easily seen in the lateral 4-chamber view. Studies that suggest an increased risk of aneuploidy when echogenic foci are seen should specify the orientation of the 4-chamber view used.