Centro Médico Profesional Rosancar. Barquisimeto, Estado Lara, Venezuela.

Case report

The following images and video show a case of the tetralogy of Fallot diagnosed at 32nd week of pregnancy.

Images 1, 2: 32 weeks of pregnancy; the images show four-chamber view of the heart. The axis of the heart is deviated to the left (74,4°). The image 2 represents a fusion of the image 1 with a drawing explaining the structures visible on the image 1 (RA - right atrium; RV - right ventricle; LA - left atrium; LV - left ventricle; Ao - aorta).

Images 3, 4: 32 weeks of pregnancy; the images show gray scale (Image 1) and power Doppler (Image 2) transverse scans of the heart with the ventricular septal defect (VSD).

Images 5, 6, and 7: 32 weeks of pregnancy; the images show the left outflow tract of the heart. The aorta is clearly overriding the ventricular septal defect and interventricular septum. The image 6 represents a fusion of the image 5 with a drawing explaining the structures visible on the image 5 (RA - right atrium; RV - right ventricle; LA - left atrium; LV - left ventricle; VSD -  ventricular septal defect). The image 7 shows color Doppler scan of the heart at the level of the overriding aorta. The flows from both ventricles are directed to the aorta. 

Images 8, 9: 32 weeks of pregnancy; the images show three-vessel view of the heart. The pulmonary artery is thin while the aorta is large (it gets the blood flow from both ventricles). The image 9 represents a fusion of the image 8 with a drawing explaining the structures visible on the image 8 (PA - pulmonary artery; Ao - aorta; SVC - superior vena cava; DA descending aorta).

Video 1: 32 weeks of pregnancy; the video summarizes the findings visible on the images above, making the final diagnosis of the tetralogy of Fallot.