The cardiac echogenic focus

Simpson, John

doi:10.1002/(sici)1097-0223(199910)19:10<972::aid-pd650>3.0.co;2-w

Cited by 12 publications

(5 citation statements)

References 21 publications

(41 reference statements)

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“…The relationship of single or multiple EIF to fetal aneuploidies is a controversial issue. 43 Our sonographic data support the study of Bromley et al, 44 who showed an increased incidence of EIF in fetuses with trisomy 21. However, a potential for misdiagnosis due to specular reflections within the fetal heart, producing echoes to be mistaken for EIF, cannot be ruled out.…”

Section: Discussionsupporting

confidence: 89%

Correlation of Prenatal Sonographic Diagnosis and Morphologic Findings of Fetal Autopsy in Fetuses With Trisomy 21

Szigeti

Csaba

Pete

et al. 2007

J of Ultrasound Medicine

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Section: Discussionsupporting

confidence: 89%

Correlation of Prenatal Sonographic Diagnosis and Morphologic Findings of Fetal Autopsy in Fetuses With Trisomy 21

Szigeti

Csaba

Pete

et al. 2007

J of Ultrasound Medicine

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“…Further, two cases had only congenital cardiac defects, one case had only extracardial defects and one case had both. Simpson (1999) carried out a systematic review of cardiac echogenic foci and the balance of current evidence appears to suggest some association between echogenic foci and fetal aneuploidy, but there is no study in the literature which has statistically demonstrated this association. Our results suggest an association between echogenic foci and chromosomal anomaly, but the number of cases in the present study is too small to draw any statistical conclusions.…”

Section: Discussionmentioning

confidence: 99%

“…Prenatally diagnosed echogenic foci in the papillary muscles of the right or left ventricle or in the chordae tendinae of fetal hearts have been reported and debated in the literature for over 10 years (Schechter et al, 1987;Levy et al, 1988;Sepulveda and Romero, 1998;Simpson, 1999;Vibhakar et al, 1999). Some authors have assumed that there is an association between these echogenic myocardial foci and chromosome anomalies (Bromley et al, 1995;Sepulveda et al, 1995;Simpson et al, 1996;Wax and Philput, 1998;Simpson, 1999;Vibhakar et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Pathologic correlation of sonographic echogenic foci in the fetal heart

et al. 2000

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The goal of the current paper is to present, on the basis of six investigated fetal hearts, the pathological substrate of prenatally, sonographically diagnosed echogenic intramyocardial foci. The right ventricle, left ventricle, interventricular septum and papillary muscles of both ventricles of six hearts of the fetuses of high-risk pregnant women showing sonographically diagnosed intramyocardial echogenic foci were investigated. At termination of pregnancy all the women were between the 20th and the 24th week of gestation. Of the six cases, four were induced abortions and two were spontaneous abortions. For the control group we investigated the hearts of two fetuses without heart defects at the 22nd and 23rd week of gestation which had proven extracardial anomalies and a normal karyotype. Both cases were induced abortions which prenatally showed no echogenic cardiac foci. In all eight cases a prenatal karyotyping was performed. In the six cases with echogenic foci the location and number of the foci were determined both prenatally and by means of histologic sections; the size of the foci was measured as well. Histological staining was with routine haematoxylin-eosin; Masson-Goldner was used for connective tissue; Kossa for calcification; and Berlin blue for haemosiderin. Histologically, in all six cases, intramyocardial calcifications surrounded by fibrotic tissue were in: papillary muscle of the left ventricle in six cases; papillary muscle of the right ventricle in one case; and the subendocardial myocardium of the right ventricle in one case. Four cases had one, one case had two and one case had three calcified foci. Three cases had cardiac and two cases had extracardiac anomalies. Four cases had chromosome anomalies: two were trisomy 21, one trisomy 13 and one triploidy. The remaining two cases had a normal karyotype. No case showed pathological changes of the chordae tendinae, myocardial cell necrosis or inflammation. There were no patho-morphological differences between the intramyocardial calcifications of the papillary muscles in cases with chromosome anomalies and with normal karyotype. As the patho-morphological correlate of the sonographically diagnosed echogenic foci, histological investigation on all six fetal hearts showed coarse intramyocardial calcifications surrounded by myocardial fibrosis. Conventional histological methods gave no indication of the cause of the intramyocardial calcifications.

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“…5 Echogenic foci within the cardiac papillary muscles have been extensively studied in associ-ation with trisomy 21. 3,4 These foci are thought to be small areas of calcification of unclear etiology. Although they may slightly increase the risk for trisomy 21, long-term follow-up of children with this prenatal diagnosis has shown that this finding does not affect heart function and is unlikely to be pathologic.…”

Section: Discussionmentioning

confidence: 99%

“…This literature has primarily detailed the natural history of mineralization of the papillary muscles, myxomas, and rhabdomyomas. [1][2][3][4][5][6][7][8] Reports describing the features and clinical importance of echogenic foci limited to the myocardium (EMF) are rare. A search of the MEDLINE database from 1966 to 2004 using the search terms fetus, myocardium, and calcification revealed 3 articles, of which only 2 addressed work in human subjects.…”

mentioning

confidence: 99%