A fetal echocardiogram is a detailed ultrasound of the baby’s heart performed before the baby is born. It is a more comprehensive evaluation of the heart than what is done during the typical obstetrical ultrasound. A fetal echocardiogram can evaluate both the structure and function of the heart. For this reason it is useful in looking for birth defects of the heart and heart rhythm problems as well as for assessing fetal well being if the baby is found to have other potential problems during the pregnancy.
There are three categories of risk factors that should prompt fetal cardiac evaluation with a fetal echocardiogram: maternal risk factors, fetal risk factors, and family risk factors. Maternal risk factors include a mother who has taken medications that are known to cause congenital heart defects, a mother who has specific health problems (such as diabetes or an autoimmune disease), or a mother who has had certain infections during the pregnancy (such as rubella or CMV). Fetal risk factors include a fetus that has been diagnosed with a genetic abnormality (such as Down syndrome) or has had an abnormal amniocentesis, a fetus who has abnormalities in other organs (such as the brain, kidney, or GI tract), a fetus with an abnormal heart rate or rhythm (too fast or too slow), or a fetus in whom a heart abnormality is suspected on a routine ultrasound. Familial risk factors include a first degree relative (father, mother, or sibling) with a congenital heart defect or a known family history of disorders that are passed from generation to generation (such as Marfan syndrome, DiGeorge syndrome, or tuberous sclerosis).
A fetal echocardiogram is generally performed by a songographer in conjunction with a pediatric cardiologist specialized in fetal congenital heart disease. A fetal echocardiogram can be performed any time after 17-18 weeks gestation, though the images are usually optimal in the 20-24 week range (a transvaginal fetal echocardiogram can be performed as early as 12-13 weeks, but this approach is not commonly used). A typical exam takes from 30-90 minutes.
Following the fetal echocardiogram, the cardiologist will sit with you and explain in detail (with pictures and diagrams) the findings of the test and what it means for you and your baby. If a congenital heart defect is identified, we will do our best to make sure you understand every aspect of the diagnosis and how it will affect the baby before delivery, during delivery, and throughout your child’s lifetime.
Dr. Tracy Laird
As we continue to experience the wonderful “arctic freeze” that is Dallas/Fort Worth, everyone is hearing of the dreaded flu outbreak that is coursing across the entire nation. As you read this article, physicians like us at PHS are getting emails about hospitals “at capacity”, and “on divert” because of so many affected by respiratory illnesses. So, it naturally leads to the question – how do illnesses like the flu and RSV affect our patients with congenital heart disease?
Heart murmurs in children are very common. A heart murmur just means a sound. Some heart murmurs are sounds produced by actual defects or abnormalities with the heart. For example, a ventricular septal defect (a hole in the wall separating the lower 2 chambers of the heart) makes a very specific noise as blood travels through the hole. Abnormalities with heart valves like aortic valve stenosis can also produce heart murmurs as blood flows past the defective valve. On the other hand, many heart murmurs are what we call innocent heart murmurs. With an innocent heart murmur, the heart is perfectly normal. The murmur in this case is simply the normal sound that blood is making as it flows through the heart.
Whenever a parent hears that their child has a heart murmur it is a scary feeling. Many questions and concerns come into focus very quickly. The word murmur is so often misused that the word itself can cause great anxiety. Murmur just means an extra sound in the heart cycle that we hear between the “lub” and the “dub”. It is typically described as a “whooshing” sound like hearing water in a hose or a faucet.
From time to time we evaluate children who are referred for an irregular heartbeat. This term typically refers to a heart rhythm that does not seem quite regular. An irregular heart beat is a little different from palpitations. The term palpitations refers to a sensation that the heart is not beating normally. Children with palpitations may feel their heart beating rapidly, pausing, or skipping beats. An irregular heartbeat, on the other hand, is usually something that a doctor hears when listening to the heart. Many children suspected of having irregular heartbeats may feel perfectly fine.