FE FE Cardiomyopathies & Tumors 2 — Questions and Answers
Question 1: On echocardiography, rhabdomyomas typically appear as:
- Hyperechoic masses within the myocardium or protruding into the cardiac cavity (Correct answer)
- Cystic structures with posterior acoustic enhancement
- Calcified masses with acoustic shadowing
- Homogeneous isoechoic pedunculated lesions
Correct answer: Hyperechoic masses within the myocardium or protruding into the cardiac cavity
Rhabdomyomas appear as well-defined, hyperechoic (bright) myocardial masses that may protrude into ventricular cavities.
Question 2: A cardiac fibroma in the fetus is most commonly located in which structure?
- Right atrial free wall
- Interventricular septum or left ventricular free wall (Correct answer)
- Pulmonary valve leaflets
- Tricuspid valve apparatus
Correct answer: Interventricular septum or left ventricular free wall
Fibromas are typically solitary tumors located in the interventricular septum or left ventricular wall and may cause outflow obstruction or arrhythmias.
Question 3: Which fetal cardiac tumor is associated with Turner syndrome and pericardial effusion?
- Rhabdomyoma
- Hemangioma
- Intrapericardial teratoma (Correct answer)
- Fibroma
Correct answer: Intrapericardial teratoma
Intrapericardial teratomas arise from the base of the great arteries and are commonly associated with large pericardial effusions and hydrops.
Question 4: Hypertrophic cardiomyopathy in the fetus of a diabetic mother most commonly affects which structure?
- Left ventricular posterior wall
- Interventricular septum (asymmetric septal hypertrophy) (Correct answer)
- Right ventricular free wall
- Left ventricular apex
Correct answer: Interventricular septum (asymmetric septal hypertrophy)
Diabetic fetopathy characteristically causes asymmetric interventricular septal hypertrophy, which may cause dynamic left ventricular outflow tract obstruction.
Question 5: Which echocardiographic finding in a fetus with hypertrophic cardiomyopathy indicates dynamic outflow obstruction?
- Fixed high-velocity jet across the pulmonary valve
- Systolic anterior motion (SAM) of the mitral valve (Correct answer)
- Diastolic mitral regurgitation
- Reversed aortic arch flow
Correct answer: Systolic anterior motion (SAM) of the mitral valve
Systolic anterior motion (SAM) of the mitral valve indicates dynamic LVOT obstruction, seen in severe hypertrophic cardiomyopathy.
Question 6: Noncompaction cardiomyopathy in the fetus is characterized by:
- Uniform wall thickening with normal trabeculation
- Excessive trabeculation with deep inter-trabecular recesses predominantly in the left ventricle (Correct answer)
- Absent ventricular trabeculae
- Isolated right ventricular hypertrophy
Correct answer: Excessive trabeculation with deep inter-trabecular recesses predominantly in the left ventricle
Left ventricular noncompaction shows excessive trabeculations with deep recesses in the non-compacted layer, predominantly in the left ventricular apex.
FE FE Cardiomyopathies & Tumors 2
On echocardiography, rhabdomyomas typically appear as: