Pediatric Heart Expert Forum
Heart Chambers
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Heart Chambers

My wife is 20wks pregnant, and we went for an ultrasound yesterday and the tech could not see all of the heart that she had hoped to see. The tech stated she could only see two heart chambers but thought the others could be there but she just couldn't get the baby to cooperate to see them. The heart rate was 158BPM and the tech could hear no blood flow or sound abnormalities when she listened to the heart. My question is can an unborn child have a normal heart rate and have no sound/blood flow abnormalities with two chambers of the heart or does it sound like the other chambers are there and she just couldn't see them? Thanks.
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Dear Osceola,

Without seeing the images, it is difficult to be able to tell you exactly what is going on with the baby’s heart.  Sometimes babies’ hearts can just be difficult to see on ultrasound, based on how they are lying within the uterus.  Also, the experience of the technician is important here, as well.  If this was a level II ultrasound, also called a targeted anomaly screen, the sonographer is not typically experienced in doing complex cardiac evaluations.  If, however, this was a fetal echocardiogram, in which the heart was specifically targeted and fully evaluated, the baby may have just been in a bad position.  Finally, the other option is that this could be severe hypoplasia of one of the major pumping chambers, either the right or the left ventricle, which is a serious and potentially lethal congenital heart defect.  Therefore, my recommendation at this point would be to have a repeat ultrasound when the baby has moved around.  If there are still problems with seeing the heart completely, your wife should have a fetal echocardiogram at a center that performs these on a routine basis, so that the anatomy, function, and flow of the heart can be completely evaluated.
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Marie M Gleason, M.D.Blank
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The Children’s Hospital of Philadelphia
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