Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association

Area of Science:

• Cardiology
• Fetal Medicine
• Medical Imaging

Background:

• Fetal cardiac medicine has seen substantial evolution over the past two decades.
• Advances in imaging technology and therapeutic innovations have driven this progress.

Purpose of the Study:

• To review the current literature on fetal cardiac medicine.
• To provide a scientific statement on the diagnosis and management of fetal cardiovascular disease.
• To outline current practices and recommendations in the field.

Main Methods:

• A comprehensive literature review was conducted by a writing group appointed by the American Heart Association.
• The American College of Cardiology/American Heart Association classification system was applied to evaluate evidence.
• Key areas reviewed include diagnosis, cardiac function assessment, treatment options, parental counseling, and delivery planning.

Main Results:

• Diagnosis of fetal cardiac disease primarily relies on ultrasound, with emerging roles for 3D/4D echocardiography, MRI, and fetal ECG/magnetocardiography.
• Medical and interventional therapies are available for select fetal conditions, including arrhythmias and heart failure.
• Strategies for delivery room care and planning improve outcomes for high-risk fetuses with congenital heart disease.

Conclusions:

• Fetal cardiac medicine is a rapidly advancing, specialized field.
• Current diagnostic tools and therapeutic interventions contribute to improved outcomes for fetuses with cardiovascular disease.
• This statement synthesizes current knowledge and recommendations based on evidence and expert experience.