Clinical Implications of the Prenatal Sonographic Finding of Fetal Myocardial Echogenic Foci

Vettraino, Ivana M.; Hoprasart, N. Jill; Bronsteen, Richard; Comstock, Christine H.

doi:10.7863/jum.2005.24.2.195

Cited by 6 publications

(2 citation statements)

References 21 publications

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“…17 Obviously, these findings have to be distinguished from echogenic intracardiac focus in the normal fetus. 36 Similar cellular mechanisms may be involved, where fibrous scar formation develops during the fetal period and subsequent rupture may occur early after birth.…”

Section: Causes Of the Diseasementioning

confidence: 99%

Acute Rupture of Chordae Tendineae of the Mitral Valve in Infants

et al. 2014

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Background— Recently, infant cases of acute heart failure attributable to rupture of the mitral chordae tendineae have been reported. However, little is known about the pathogenesis and clinical course of this condition. Methods and Results— Ninety-five children with rupture of mitral chordae tendineae were identified in nationwide surveys of Japan diagnosed from 1995 to 2013. The clinical manifestations, management strategies, and prognosis were investigated. Eighty-one (85%) patients were between 4 and 6 months (median, 5 months) of age. In 63 (66%) patients, rupture occurred during the spring or summer. The underlying conditions before rupture included Kawasaki disease (10 cases), maternally derived anti-SSA antibodies (2 cases), and infective endocarditis (1 case). Surgery was performed in 80 patients (94 operations), and the final operations included plasty of mitral chordae in 52 cases and mechanical valve replacement in 26 cases. The histopathologic examinations of the mitral valves and chordae (n=28) revealed inflammatory reactions with predominant mononuclear cell infiltration in 18 cases (64%) and increased fibrous and myxoid tissue in 11 cases (39%), suggesting that nonbacterial infectious or autoimmune endocarditis and myxoid changes are involved in the pathogenesis. Eight patients (8.4%) died before (n=6) and shortly after (n=2) the operation, and significant neurological complications persisted in 10 cases (11%). Conclusions— Acute heart failure attributable to rupture of the mitral chordae tendineae in infants is a unique disease resulting from diverse causes. This condition should be recognized as a significant cardiovascular disorder that may cause sudden onset of cardiogenic shock and death in infants.

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Section: Causes Of the Diseasementioning

confidence: 99%

Acute Rupture of Chordae Tendineae of the Mitral Valve in Infants

et al. 2014

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“…Focos ecogênicos localizados no miocárdio são raros e tampouco apresentam significado patológico 156 .…”

Section: Foco Ecogênico Intracardíacounclassified

Relação entre a medida da translucência nucal no primeiro trimestre e a presença de marcadores ultrassonográficos para a Síndrome de Down no segundo trimestre da gestação

Miguelez¹

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e de realizar esta tese.À Prof. Dra. Maria de Lourdes Brizot, minha orientadora, pela confiança em mim depositada, por sua dedicação, integridade e generosidade.Ao Prof. Dr. Adolfo Wenjaw Liao, pelas sugestões pertinentes na fase de desenho do estudo, pela amizade e pela contribuição atenta e enriquecedora no exame de qualificação.Ao Prof. Dr. Victor Bunduki, a quem devo minha formação inicial em Medicina Fetal, pela sua participação no projeto do estudo, pela amizade, apoio e incentivo.Ao Prof. Kypros Nicolaides, que completou minha formação em Medicina Fetal e contribuiu para aperfeiçoar este trabalho, ao me convidar para apresentá-lo e discuti- A pesquisa de marcadores ultrassonográficos no segundo trimestre da gestação, após rastreamento combinado no primeiro, parece elevar substancialmente as taxas de detecção de Síndrome de Down, mas está amparada na assunção não comprovada de independência entre esses testes. O presente estudo investigou a relação entre a translucência nucal e uma série de marcadores ultrassonográficos no segundo trimestre. A medida da translucência nucal no primeiro trimestre era seguida pela realização da ultrassonografia morfológica entre 18 a 23 semanas e 6 dias de gestação, incluindo a pesquisa de três marcadores qualitativos (foco ecogênico intracardíaco, intestino hiperecogênico e defeito estrutural) e as medidas do osso nasal, da prega nucal, do comprimento do úmero, do comprimento do fêmur, do diâmetro anteroposterior das pelves renais e da espessura pré-nasal. Genetic sonogram following first trimester combined screening appears to substantially increase detection rates for Down syndrome but it relies on the unproved assumption of independence between these tests. In this study we have investigated the relation of first trimester nuchal translucency to a series of secondtrimester soft markers. Nuchal translucency (NT) measurement in the first trimester was followed by second trimester scan (18-23w+6 days) including search for three categorical soft-markers (intracardiac echogenic foci, hyperechogenic bowel and structural defects) and measurements of nasal bone length, nuchal fold thickness, femur length, humerus length, renal pelvices diameter and prenasal thickness. All continuous variables were expressed in multiples of the medians for gestation (MoMs) and correlation coefficients between log-transformed NT and second trimester variables were calculated. In addition, frequencies of classical soft-markers in cases with increased NT were compared to those with normal NT, using MoMs cutoffs. In a dataset of 1970 cases, NT was significantly correlated (p<0.05) to all second trimester continuous variables, in particular to nuchal fold thickness (r=0.10).There was a higher frequency of cases with second trimester nuchal fold thickness above the 95th centile (10.7% versus 2.2%) and hyperechogenic bowel (2.4% versus 0.1%) in cases with increased NT. In conclusion, straightforward reassessment of risk using likelihood ratios derived from the classical genetic sonogram might lead to ina...

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Current awareness in prenatal diagnosis

2005

Prenat. Diagn.

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of prenatal diagnosis. Each bibliography is divided into 17 sections: 1 Books, Reviews & Symposia; 2 General Interest; 3 Normal Fetal Development; 4 Gametogenesis and Pre‐implantation Diagnosis; 5 First Trimester Diagnosis; 6 Second Trimester Diagnosis; 7 Fetal Diagnosis by Ultrasound and Other Imaging; 8 Maternal Screening; 9 Screening for Carriers of Genetic Abnormality; 10 Technological Developments; 11 Confined Placental Mosaicism and Uniparental Disomy; 12 Molecular Cytogenetics; 13 Fetal Cells in Maternal Circulation; 14 Fetal Therapy; 15 Psychosocial Aspects; 16 Epidemiology and Environmental Factors; 17 Developmental Pathology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted

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Clinical Implications of the Prenatal Sonographic Finding of Fetal Myocardial Echogenic Foci

Abstract: The prenatal identification of EMF is unlikely to lead to notable short-term pathologic conditions because the fetuses in this investigation had unremarkable neonatal and pediatric echocardiograms and normal cardiac function.

Cited by 6 publications

References 21 publications

Acute Rupture of Chordae Tendineae of the Mitral Valve in Infants

Acute Rupture of Chordae Tendineae of the Mitral Valve in Infants

Relação entre a medida da translucência nucal no primeiro trimestre e a presença de marcadores ultrassonográficos para a Síndrome de Down no segundo trimestre da gestação

Current awareness in prenatal diagnosis

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