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  2. Library: Normal Fetal Anatomy Module
  3. Lesion: Fetal Views: Apical 4 Chamber
  4. View: Fetal Echo Clips: Apical 4 Chamber
  • Fetal Apical 4 Chamber View
    • Normal fetal 4 chamber view
    • Slight inferior displacement of the tricuspid valve compared to the mitral valve with chordal attachments from the tricuspid valve septal leaflet to the ventricular septum
    • Smooth endocardial surface of the left ventricle
    • Moderator band in the right ventricular apex
    • Normal sized ventricles and AV valves
    • Normal biventricular systolic function
    • Echogenic focus in LV near mitral valve chordae/pappillary muscle (normal variant)
  • Fetal Apical 4 Chamber View
    • Normal fetal 4 chamber view
    • Normal sized ventricles and AV valves
    • Normal biventricular systolic function
  • Fetal Apical 4 Chamber View
    • Normal fetal 4 chamber view
    • Normal sized ventricles and AV valves
    • Color Doppler with normal laminar tricuspid and mitral valve inflow
    • No tricuspid or mitral regurgitation
  • Fetal Apical 4 Chamber View (outflow tract sweep)
    • Normal fetal 4 chamber view
    • Sweep towards outflow tracts
    • Great arteries arise from appropriate ventricles (aorta arises from LV and pulmonary artery from RV at end of sweep)
    • Normal crossing of great arteries
    • Small pericardial effusion (likely physiologic)
  • Fetal Apical 4 Chamber View (outflow tract sweep)
    • Normal fetal 4 chamber view
    • Sweep towards outflow tracts
    • Great arteries arise from appropriate ventricles (aorta arises from LV and pulmonary artery from RV at end of sweep)
    • Normal crossing of great arteries
  • Fetal Apical 4 Chamber View (outflow tract sweep)
    • Sweep towards outflow tracts with color Doppler
    • Great arteries arise from appropriate ventricles (aorta arises from LV and pulmonary artery from RV at end of sweep)
    • Normal crossing of great arteries
    • Normal laminar flor across outflow tracts and semilunar valves 
    • No ventricular level shunting (fetal echo cannot rule out small VSDs)
  • Fetal Apical 4 Chamber View (outflow tract sweep)
    • Sweep towards outflow tracts
    • Great arteries arise from appropriate ventricles (aorta arises from LV and pulmonary artery from RV at end of sweep)
    • Normal crossing of great arteries
    • No obvious ventricular level shunting (fetal echo cannot rule out small VSDs)
  • Fetal Apical 4 Chamber View (pulmonary veins)
    • Two right and one left pulmonary vein seen returning normally to the left atrium
  • Fetal Apical 4 Chamber View (pulmonary veins)
    • Zoomed up view of left atrium
      • Two right and two left pulmonary veins seen returning normally to the left atrium
  • Fetal Apical 4 Chamber View (pulmonary veins)
    • Normal spectral Doppler pattern in a fetal pulmonary vein
  • Fetal Apical 4 Chamber View (pulmonary veins)
    • Normal spectral Doppler pattern in a fetal pulmonary vein
  • Fetal Apical 4 Chamber View (arch sidedness)
    • Fetal apical 4 chamber view sweep towards outflow tracts
    • The pulmonary artery and aorta arise normally from their respective ventricles
    • At the end of the sweep the aorta is seen leftward of the trachea confirming a left-sided fetal aortic arch

These are normal fetal echo clips from an apical 4 chamber view. 

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