Significance of Echogenic Cardiac Nodule in Fetus as Soft Marker

Abstract

Introduction: The purpose of this study was to determine the pathological significance of echogenic cardiac nodule in the heart of fetuses with no other sonographic abnormalities and in the absence of other risk factors for chromosomal abnormality. A common ultrasound finding in relation with fetal abnormality was identified as echogenic foci. The association of this soft marker abnormality was less known. Aim: The aim of this study was to document the outcome of fetuses having single or multiple echogenic cardiac foci with no maternal risk factors for chromosomal abnormality in Central Maharashtra. Materials and Methods: The location and number of echogenic cardiac nodule on fetal scans were recorded prospectively for fetuses seen at the Tertiary Hospital, Kumbhari, Maharashtra, India, between May to December 2016. A total of 71 fetuses were identified with single or multiple echogenic cardiac nodules. This represents 17.2% of the total number of fetuses scanned (n=413). Results: The most frequent finding was a single echogenic cardiac nodule (n=62, 87.3%), but multiple foci were also observed in 9 (12.6%). The most common findings were isolated echogenic foci, 64 (90.1%), in the left ventricle. An echogenic cardiac nodule in the right ventricle occurred in 2 cases (2.8%). Associated abnormalities were diagnosed in 5 fetuses, each one of bilateral club foot (1.4%), Left PUJ obstruction (1.4%), microcephaly (1.4%), Rhizomelic dwarfism (1.4%), Sacro coccygeal teratoma (1.4%). Postnataly in two patients Trisomy 21 (2.8%) was identified. The majority of fetuses which had echogenic cardiac nodule were normal. Conclusion: We emphasize that single ecogenic cardiac focus is very common finding in our study. If it is not associated with other structural abnormalities, need to perform invasive genetic diagnostic tests may not be warranted.

Keywords

• echogenic cardiac foci
• left ventricle
• trisomy 21
• ultrasonography