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Fetal cardiomegaly

Dr Abhilash Sandhyala and Radswiki et al.

Fetal cardiomegaly (FC) essentially refers to an enlarged fetal heart. It is variably defined with some sources stating the cut off as a fetal cardio-thoracic circumference above two standard deviations ⁷.

Pathology

It can arise from a number of situations which include

congenital cardiac anomalies : particularly
- tricuspid atresia - tricuspid dysplasia ¹
- Ebstein anomaly ¹
twin pregnancy related complications : in recipient twin in twin-ywin transfusion syndrome
fetal dilated cardiomyopathies
due to abnormal shunting
- fetal arterio-venous malformations : vein of Galen malformation ^2-3
- placental chorioangioma ⁶
in association with hydrops fetalis ² - this includes the many causes of hydrops fetalis
endocardial fibroelastosis

Chamber involvement - distribution

In the vast majority of cases the cardiac enlargement involves the right sided chambers with the right atrium being involved in ~ 90% of cases.

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