Hypoplastic left heart syndrome - antenatal

Case contributed by Bahman Rasuli
Diagnosis certain


Primigravida with an antenatal scan at 20 weeks.

Patient Data

Age: 25 years
Gender: Female

There was normal fetal situs.

The left ventricle is atretic on 4-chamber view.

Small left atrium.

Mitral atresia and no flow through the valve.​

The right atrium and right ventricle are enlarged because of the alterations in hemodynamics.

Double outlet right ventricle with the origination of the aorta and pulmonary artery with antegrade flows from the right ventricle is seen.

The size discrepancy of the enlarged pulmonary artery and smaller aorta also is present. 

The rest of the fetal anatomical survey was normal.

Fetal maturity corresponded to LMP.

Case Discussion

The 4 chamber view is particularly helpful in initial in-utero assessment. May show a small ascending aorta, and a small but thick-walled left ventricle while the right heart chambers may appear enlarged. The movement of the mitral valve may also appear significantly impaired.

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