Premature atrial contractions in a bigeminy pattern (fetal echocardiography)
Diagnosis certain
Presentation
A 30-year-old pregnant woman was referred for fetal echocardiography because of arrhythmias seen on routine obstetric sonography.
Patient Data
Age: 30 years
Gender: Female
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/124407/annotated_viewer_json?iframe=true\u0026lang=us"}
- pulsed-wave Doppler recording from the left ventricular outflow tract (LVOT) in a fetus with premature atrial contractures (PACs)
- the PACs are seen in a bigeminy pattern (occurring in every other beat)
- the Doppler wave pattern of PACs shows only an A wave without a preceding E wave because they are fused
- PAC referred to premature atrial contraction
- A wave is related to atrial contractions
- E wave is due to early filling Doppler wave from the right ventricular inflow
Case Discussion
Fetal echocardiography revealed a fetus with premature atrial contractions (PACs) in a bigeminy pattern that is usually benign. PACs in association with impaired cardiac function will predict supraventricular tachycardia and should be closely observed until PACs resolve or until delivery.