Congenital heart disease echocardiography

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Keri Shafer, M.D. [2], Atif Mohammad, M.D., Priyamvada Singh, MBBS

## Echocardiography

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#### Fetal Echocardiography

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Fetal Echocardiography (M-Mode) along with Doppler ultrasonography, have helped to diagnose the abnormalities in structure and function of fetal heart in utero. It could be done as early as 16 weeks of gestation. It has helped the physicians to make better management plans for pregnancy, delivery, post-natal period and parental counseling. M-mode Echocardiography can also pick arrhythmia in utero. The early detection of arrhythmia is of great importance, as it could be treated by maternal administration of anti-arrhythmic drugs like digoxin, procainamide, propranolol (reaches the fetus transplacentally)or could be directly injected to the umbilical veins of fetus.

#### Echocardiography in Newborns and Adults

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It has become the standard for diagnosis of congenital heart malformations. It could diagnose malformations like coarctation of aorta, patent ductus arteriosus, hypoplastic left heart syndrome and others with great confidence.[1] Patent ductus arteriosus is a poor example as its patency is physiological during pregnancy. Coarctation of aorta is a very difficult diagnosis during fetal life and also a poor example of the great performance of featl cardiac ultrasonography.

## 2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[2]

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### Recommendations for Echocardiography

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Class I

1.Intraoperative TEE is recommended to guide surgical repair of CHD in adults. (Level of Evidence: B-NR)
2.Patients with ACHD should undergo transthoracic echocardiography (TTE) for initial assessment, with timing of serial assessment based on anatomic and physiological severity and clinical status.(Level of Evidence: C-EO)

## References

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1. ↑ Braunwald Zipes Libby. Heart disease: A textbook of cardiovascular medicine, 6th Edition chapter 43:W.B. Saunders ;.pp 1523
2. ↑ Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM; et al. (2019). "2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". J Am Coll Cardiol. 73 (12): 1494–1563. doi:10.1016/j.jacc.2018.08.1028. PMID 30121240.CS1 maint: Multiple names: authors list (link)

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Congenital malformations and deformations of circulatory system (Q20-Q28, 745-747)

Cardiac chambers and connections|

Persistent truncus arteriosus \- Double outlet right ventricle (Taussig-Bing syndrome) - Transposition of the great vessels (dextro, levo)

Cardiac septa|

Ventricular septal defect \- Atrial septal defect (Lutembacher's syndrome) - Atrioventricular septal defect (Ostium primum) - Tetralogy of Fallot \- Eisenmenger's syndrome

Right: pulmonary and tricuspid valves|

pulmonary valves (stenosis, insufficiency) - tricuspid valves (stenosis, atresia) - Ebstein's anomaly

Left: aortic and mitral valves|

aortic valves (stenosis, insufficiency, bicuspid) - mitral valves (stenosis, regurgitation) - Hypoplastic left heart syndrome

Other congenital malformations
of heart|

Dextrocardia \- Levocardia \- Cor triatriatum

Great arteries|

aorta (Patent ductus arteriosus, Aortic coarctation, Interrupted aortic arch, Overriding aorta, Aneurysm of sinus of Valsalva, Vascular ring) - Pulmonary atresia

Great veins|

Persistent left superior vena cava \- Total anomalous pulmonary venous connection \- Scimitar syndrome

Other|

Arteriovenous malformation (Cerebral arteriovenous malformation)

See also non-congenital conditions (I, 390-459)

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