It is a condition that occurs in the fetal heart as a result of the increase in the echogenicity of the papillary muscle of the heart. Diagnosis is made by ultrasonography with a bright white focal image inside the heart. It is much more common in the left ventricle of the heart. It is usually smaller than 3 mm in diameter.
Diagnosis: Diagnosis can be easily made by ultrasonography. There is a bright white focal appearance inside the heart. The hyperechoic focus is bone bright. Its incidence in the left ventricle is 4 times higher than in the right ventricle. The incidence of bilateral hyperechoic focus is approximately 5%.
Clinical Importance: Hyperechoic focus occurs as a result of increased mineralization in the normal papillary structure within the heart. Its incidence in fetuses in the second trimester is approximately 3-4%. While this is seen frequently in all pregnancies, it is seen 18% in Trisomy-21 (Down syndrome) cases and 39% in Trisomy-13 cases. The incidence of Trisomy-21 and Trisomy-13 increases, especially if there are additional anomalies. Therefore, when a hyperechoic focus in the heart is diagnosed, it should be carefully searched for additional anomalies. If another ultrasonography finding suggesting chromosomal anomaly is detected, the pregnant woman is considered high risk and chromosome analysis with amniocentesis or cordocentesis is required. If no additional anomaly is detected, the pregnant woman is considered to be at low risk for chromosomal anomaly. It can be said that the risk of Trisomy-21 increases approximately 1.8 times in low-risk pregnant women.
Prognosis: If no additional anomaly is observed in the fetus other than a hyperechoic focus, the prognosis is good. Unless there is a chromosomal anomaly, it can be said that the detected hyperechoic focus formation does not cause a problem in the fetus. These babies are not expected to encounter any problems in their general health due to this formation in the remaining periods of their lives.
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