Echogenic Intracardiac Foci

Ashish Jain, Bijaylaxmi Behhra

Case Scenario

A 23-year-old primigravida underwent a level 2 antenatal ultrasonography (USG) screening at 22 weeks of gestation. The USG was suggestive of an echogenic focus in the left ventricle. A detailed evaluation did not reveal any other fetal anomaly.

Echogenic Intracardiac Focus

An echogenic intracardiac focus (EIF) is a small structure within the fetal heart with an echogenicity similar to or greater than that of the surrounding bone, apparent during an antenatal USG. It is sometimes referred to as a “golf ball.” An EIF is usually a normal variant, observed in 5% of all fetuses during the second trimester USG. Multiple foci have been noted in 6% to 11% of fetuses. Biventricular foci are more frequently associated with autosomal trisomies. Studies report the presence of the foci in the left ventricle in 87.6% of both aneuploidy and euploidy cases, in the right ventricle in about 0% to 25% of the cases, and in both ventricles in 1.5% to 7.6% of cases.

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