Service de Medecine foetale IPP, Paris, France

This is a 35 year-old primigravida with unremarkable medical history referred at 22 weeks due to a cardiac anomaly. The karyotype was normal. There were no other malformations.

These were the ultrasound findings:

• left ventricle with thickened hyperechoic and severely hypokinetic walls
• mitral valve stenosis
• aortic valve stenosis

The diagnosis of endocardial fibroelastosis was proposed and confirmed by pathology demonstrating the thickened walls and the porcelain-like endocardium.