First AD

Second AD

Fetal echocardiography performed on a late second trimester fetus shows an anomaly. The arrows point to the aortic valve. What’s your diagnosis?

The aortic valve normally has 3 cusps, which allow the flow of blood from the left ventricle to the aorta. In this case, the fetal aortic valve shows only 2 cusps, or is bicuspid. This gives it the characteristic fish-mouth appearance. This anomaly is generally not detected much later in life, because most persons with this cardiac defect remain asymptomatic until well into adulthood.

Pregnancy and Birth

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Challenge your diagnostic skills: Can you identify this cardiac defect?

Image IQ: The Heart of the Matter

Joe Antony, MD