Fetal endocarditis in left atrial isomerism - a case report

Area of Science:

• Cardiology
• Fetal Medicine
• Pathology

Background:

• Fetal endocarditis is a rare condition that can lead to significant morbidity and mortality.
• Congenital heart defects (CHDs) are common in fetuses and can be associated with various complications.
• Left atrial isomerism and complete congenital heart block represent complex CHDs.

Purpose of the Study:

• To report a unique case of coexisting fetal endocarditis and a complex congenital heart defect.
• To investigate the potential role of fetal echocardiography in diagnosing fetal endocarditis.
• To correlate echocardiographic findings with postmortem pathological results.

Main Methods:

• Serial fetal echocardiography from 32 to 39 weeks of gestation.
• Postmortem examination including autopsy, histopathology, and immunohistochemistry.
• Fetal Doppler echocardiography to assess blood flow patterns.

Main Results:

• The fetus presented with a common atrium (left atrial isomerism) and complete congenital heart block.
• Postmortem examination confirmed endocarditis.
• Fetal Doppler echocardiography showed abnormal turbulent systolic and diastolic flow in the semilunar valve.

Conclusions:

• Fetal endocarditis can coexist with complex congenital heart defects.
• Abnormal turbulent valve flow on fetal Doppler echocardiography may suggest fetal endocarditis, even without visible vegetations.
• Early detection and understanding of fetal endocarditis are crucial for improved outcomes.