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Left ventricular echogenic focus in the fetal heart: pathologic correlation
D L Brown1, D J Roberts, W A Miller
1Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
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Echogenic foci in the fetal heart
Area of Science:
- Cardiology
- Fetal Medicine
- Pathology
Background:
- Echogenic foci in the fetal left ventricle are common sonographic findings.
- Their exact cause and location are often speculative.
- They are generally considered a normal variant.
Purpose of the Study:
- To determine the cause and location of echogenic foci in the fetal left ventricle.
- To correlate sonographic findings with pathologic examination.
Main Methods:
- Retrospective review of three fetal cases with sonographic echogenic foci.
- Pathologic examination of cardiac tissue.
Main Results:
- Mineralization within the papillary muscle was the consistent histologic finding.
- Chordae tendineae were normal in all cases.
- One fetus had trisomy 21.
Conclusions:
- Echogenic foci in the fetal left ventricle represent papillary muscle mineralization.
- These foci should be considered a normal variant pending further data on aneuploidy association.
Abstract:
Echogenic foci within the left ventricle of the heart have been found in a minority of fetuses and generally are believed to be a normal variant. The cause and exact location of these foci have remained speculative, however. We identified three fetuses with this sonographic finding in whom pathologic correlation was available. The only consistent histologic finding present in all three fetuses was mineralization within a papillary muscle; the chordae tendineae were normal. One of the three fetuses had trisomy 21. Echogenic foci within the left ventricle of the fetal heart represent papillary muscle mineralization. Until more data are available to investigate any possible association with aneuploidy, an echogenic focus in the left ventricle should still be considered a normal variant.