FETAL HEART
NORMAL POSITION
- MOSTLY LEFT CHEST
- APEX POINTS TO THE LEFT
- RT VENTRICLE ANTERIOR
- LT ATRIUM POSTERIOR
- FETAL HEART MORE HORIZONTAL
IN CHEST DUE TO LARGE LIVER
Normal axis = 45 ± 20° (2 standard deviations).
Normal range = 22°-75° (1).
normal fetal heart rate
NORMAL = 120-160 BPM
NORMAL: IMAGE 1
SITUS -
LEVEL OF STOMACH BELOW HEART
HEART AXIS
Levocardia
The cardiac apex points to the left
(normal).
HEART AXIS
Mesocardia:
The cardiac apex points to the
midline.
HEART AXIS
Dextrocardia:
The cardiac apex points to the right
IMAGE 2:
4 CHAMBER HEART
4CH HEART
what plane?
what level?
each side…
types?
NORMAL FOUR-CHAMBER VIEW
- TRANSVERSE PLANE OF THE CHEST
- LEVEL OF THE FOURTH RIB
- ONE COMPLETE RIB ON EACH SIDE OF LATERAL CHEST
WALL - TYPES - APICAL; SUBCOSTAL
normal situs has…
- apex heart and stomach on left
side - IVC on left
normal cardiac axis
45 degrees (range 25-65 degrees) in left chest
two atria (characteristics)
Two ventricles (characteristics)
Equal size
Morphologic LA and RA
Flap of foramen ovale in LA
Atrio-ventricular concordance
Two ventricles:
Equal in size and contractility
Morphologic LV and RV
Moderator band (MB) in RV
APICAL FOUR CHAMBER VIEW OF THE HEART
TRANSVERSE VIEW OF FETAL CHEST
APEX OF THE HEART POINTING DIRECTLY TOWARD OR AWAY FROM
TRANSDUCER
INTERVENTRICULAR SEPTA AND INTERATRIAL SEPTA ARE PARALLEL TO THE
TRANSDUCER
MODERATOR BAND IN RV (ARROW)
Moderator band
location?
function?
location:
located in the right ventricular apex that connects the
interventricular septum to the anterior papillary muscle. When looking within
the heart it appears as any other trabecula would except that the moderator
band does not seem to be attached to one single side but rather crossing the
lower portion of the right ventricular chamber.
function:
to act as a primary conduction path into the
free wall originating from the right bundle branch.
SUBCOSTAL FOUR CHAMBER VIEW OF THE HEART
how is image obtained?
what structures can you see in this view?
THIS VIEW IS OBTAINED BY IMAGING THE FETAL CHEST IN A TRANSVERSE
PROJECTION FROM THE ANTERIOR CHEST WALL AND ANGLING
-THE
TRANSDUCER IN A CEPHALAD DIRECTION
Image 3:
LVOT
LVOT (AORTA)
THE AORTA ARISES FROM THE POSTERIOR ASPECT OF THE LEFT VENTRICLE
THE AORTA (AO) AND PULMONARY ARTERY (PA) CROSS OVER EACH
OTHER AS THEY EXIT THEIR RESPECTIVE VENTRICLES OF THE HEART
FIVE CHAMBER VIEW OF THE HEART
ULTRASOUND
THE FIVE CHAMBER VIEW IS OBTAINED BY ANGLING THE TRANSDUCER
CEPHALAD AND ANTERIOR FROM THE FOUR CHAMBER VIEW.
Image 4:
RVOT
what can you see in RVOT
RVOT (PULMONARY ARTERY)
THE PULMONARY ARTERY ARISES FROM THE ANTERIOR ASPECT OF
THE RIGHT VENTRICLE
Image 5:
VESSEL VIEW
3 Vessel view
what does it demonstrate?
how is it obtained?
DEMONSTRATES THE RELATIONSHIP BETWEEN THE AORTA,
PULMONARY ARTERY AND SUPERIOR VENA CAVA.
THIS VIEW IS OBTAINED BY ANGLING THE TRANSDUCER CEPHALAD FROM THE
FOUR-CHAMBER VIEW TO THE LEVEL OF THE FETAL MEDIASTINUM.
Images 6 and 7
LONGITUDINAL and SAGITTAL VIEWS
IMAGE A: DUCTAL ARCH
IMAGE B: AORTIC ARCH
how is LONGITUDINAL / SAGITTAL VIEWS OF THE
OUTFLOW TRACTS images obtained
THIS VIEW IS OBTAINED BY CONTINUING TO ROTATE THE TRANSDUCER FROM THE
LONG-AXIS VIEW OF THE LEFT VENTRICLE TO AN ALMOST SAGITTAL VIEW OF THE
FETUS.
THIS RESULTS IN THE “HOCKEY STICK” APPEARANCE OF THE PULMONARY ARTERY
- DUCTUS OUTFLOW TRACT.
what is this image of
SAGITTAL VIEW – DUCTAL ARCH (“HOCKEY STICK”)
