FE Cheat Sheet 2026

The 30 highest-yield FE facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. In a healthy fetus, the Doppler waveform at the ductus venosus during atrial contraction (a-wave) should be: → Forward (positive) flow
2. Color Doppler aliasing in fetal echocardiography indicates: → Flow velocity exceeding the Nyquist limit
3. Which fetal cardiac defect is most likely responsible for a markedly enlarged, globular heart occupying most of the thorax with severe tricuspid regurgitation? → Severe Ebstein anomaly
4. A reversed a-wave in the ductus venosus Doppler suggests: → Elevated right atrial pressure or cardiac compromise
5. The normal combined cardiac output (CCO) in a near-term fetus is approximately: → 300–500 mL/kg/min
6. Parvovirus B19 infection in the fetus primarily causes cardiac compromise through: → Severe fetal anemia causing high-output cardiac failure
7. By what gestational week is cardiac septation (atrial and ventricular) normally complete in the human embryo? → Week 7–8
8. Which cardiomyopathy pattern is most commonly associated with poorly controlled maternal diabetes? → Hypertrophic cardiomyopathy with septal hypertrophy
9. In a dichorionic-diamniotic twin pregnancy, which specific complication most strongly warrants fetal echocardiography for both twins? → Twin-to-twin transfusion syndrome (TTTS)
10. The myocardial performance index (Tei index) in fetal echocardiography is calculated as: → (IVCT + IVRT) / Ejection time
11. Which technique is used to evaluate fetal heart rhythm? → M-mode
12. In fetal echocardiography, the ductus venosus waveform is normally characterized by: → Triphasic flow with S, D, and a-wave, all in forward direction
13. At what gestational age does the fetal heart typically begin to beat? → 5-6 weeks
14. Which echocardiographic view best identifies ventricular septal defects (VSD)? → Four-chamber view
15. A pregnant patient on lithium therapy is referred for fetal echocardiography. Which cardiac anomaly is specifically associated with lithium exposure? → Ebstein anomaly of the tricuspid valve
16. Fetal cardiac rhabdomyomas are associated with which genetic condition in up to 80% of cases? → Tuberous sclerosis complex
17. Which Doppler waveform index is most commonly used to assess umbilical artery resistance? → Pulsatility index (PI)
18. During cardiac development, neural crest cells primarily contribute to formation of which structure? → Conotruncal septum and great vessel walls
19. Complete fetal heart block is most strongly associated with which maternal antibody? → Anti-Ro/SSA and anti-La/SSB antibodies
20. Which finding on fetal echocardiography suggests cardiac dysfunction in a hydropic fetus? → Cardiomegaly with cardiothoracic ratio >0.50
21. What is the primary purpose of using a high frame rate (>100 fps) in fetal echocardiography? → To accurately capture rapid cardiac events such as valve motion in a high-heart-rate fetus
22. Which antiarrhythmic drug is most commonly used as first-line transplacental therapy for fetal SVT? → Digoxin
23. Which cardiac defect results from failure of the aortopulmonary septum to spiral normally? → D-transposition of the great arteries
24. Which fetal cardiac tumor is associated with Turner syndrome and pericardial effusion? → Intrapericardial teratoma
25. When performing fetal echocardiography, which view is obtained by rotating the transducer 90° from the four-chamber view toward the fetal left shoulder? → Long-axis left ventricular outflow tract view
26. In fetal cardiac biometry, z-scores normalize measurements primarily against which parameter? → Estimated fetal weight or gestational age
27. Which finding on the four-chamber view suggests total anomalous pulmonary venous return (TAPVR)? → Enlarged right atrium and ventricle with no pulmonary veins draining to the left atrium
28. What is the expected right ventricular (RV) to left ventricular (LV) size relationship in a normal fetus on the four-chamber view? → Approximately equal, with the RV mildly dominant (RV:LV ≈ 1.0–1.1)
29. What fetal heart rate range on a routine obstetric scan would most appropriately trigger referral for fetal echocardiography to evaluate arrhythmia? → Sustained rate below 100 bpm or above 180 bpm
30. The ISUOG guideline recommends obtaining a fetal echocardiogram at what gestational age for optimal image quality? → 18–22 weeks