Parinatology Unit, Villavicencio, Meta, Colombia.
A 24-year-old woman (G2P1), with a non-contributive family history was referred to our unit at 33 weeks due to a fetal cardiomegaly. Our examination showed:
A fetal heart enlargement with global dilation of the ventricles and atria, with predominant enlargement of the left parts of the heart, mainly of the left atrium;
Marked mitral regurgitation;
Retrograde blood flow within the aortic arch.
The findings were suggestive of aortic atresia. An elective Cesarean section was done at 38 weeks and the newborn showed poor neonatal adaptation with signs of the cardiac insufficiency. The postnatal ultrasound found severe dilated cardiomyopathy with poor contractions of the left ventricle, but without aortic atresia, stenosis or coarctation. The cardiomyopathy had probably diminished the left ventricular systolic function, causing a "functional aortic atresia" without anatomic atresia. TORCH infections were excluded. The neonate died the next day after delivery, but no other examinations were performed.
Images 1, 2: The images show four-chamber view of the heart with marked dilatation of the chambers, predominantly of the left atrium.