Cardlac malformations (pulmonary trunk stenosis, ventricular septal defect, and double outlet right ventricle) were induced by the administration of two doses of retinoic acid (RA) to Wistar rats on d 13 of pregnancy. Contractile performance of the isolated perfused rat heart and its inotropic response to Ca2+ (0.6-10.0 mmol . L -I ) was studied in 20-d-old fetuses. The body welght of RA-exposed fetuses was significantly lower compared with controls. RA negatively influenced the contractile parameters of the fetal rat heart. The most pronounced effect was, except at a ca2+ concentration of 2.5 mmol L-I, observed at developed force at all other concentratlons. Simultaneously, the sensitivity to ca2+, expressed as the ca2+ concentrat~on at which 30% of maxlmum was attained, was significantly lower in RA-exposed hearts. This implies that the malformed heart is more dependent on the extracellular sources of Ca2+. (Pediatr Res 38: 892-895, 1995) Abbreviations RA, retinoic acid ed, embryonic day DF, developed force (+dF/dt),,,, rate of maximal contraction (-dF/dt),,,, rate of maximal relaxation CHD, congenital heart disease TGA, transposition of great arteries DORV, double-outlet right ventricle VSD, ventricular septal defect