Clinical Indications & Risk Factors Flashcards

A pregnant patient is incidentally found to have a bicuspid aortic valve. What is the recurrence risk implication for her fetus?

Answer: Approximately 9-10% risk of the fetus inheriting a left-sided obstructive lesion

Left-sided obstructive lesions including bicuspid aortic valve have familial clustering with approximately 9-10% recurrence risk, justifying fetal echocardiography.

Which of the following best describes the recommended screening approach when a prior sibling had hypoplastic left heart syndrome (HLHS)?

Answer: Fetal echocardiography is strongly indicated due to ~2-4% recurrence risk

HLHS has a recurrence risk of approximately 2-4% in subsequent siblings, warranting targeted fetal echocardiography at 18-22 weeks.

Prolonged fetal supraventricular tachycardia (SVT) without treatment can lead to which serious complication requiring echocardiographic monitoring?

Answer: Fetal hydrops due to high-output cardiac failure

Untreated fetal SVT causes sustained high output state leading to ventricular dysfunction, venous congestion, and ultimately fetal hydrops.

A patient undergoes IVF and is now 10 weeks pregnant with a monochorionic-diamniotic twin gestation. What is the most appropriate cardiac surveillance plan?

Answer: Fetal echocardiography is warranted due to increased CHD risk associated with both IVF and monochorionic twinning

IVF itself is associated with a modestly elevated CHD risk, and monochorionic twins carry added risk from potential TTTS; together they support early echocardiographic referral.

A fetus is diagnosed with a diaphragmatic hernia. Why is fetal echocardiography indicated even without a suspected primary cardiac anomaly?

Answer: Congenital diaphragmatic hernia has a 10-15% association with structural congenital heart defects and alters cardiac anatomy

Congenital diaphragmatic hernia is associated with approximately 10-15% co-occurrence of structural heart defects and causes cardiac displacement and compression affecting hemodynamics.

Which maternal connective tissue disorder, aside from SLE, carries risk for fetal heart block due to circulating antibodies?

Answer: Sjögren syndrome with anti-Ro/SSA antibodies

Sjögren syndrome, like SLE, can produce anti-Ro/SSA and anti-La/SSB antibodies that cross the placenta and cause neonatal lupus with congenital heart block.

In a fetus with confirmed Turner syndrome (45,X), which cardiac lesion should be specifically investigated on fetal echocardiography?

Answer: Bicuspid aortic valve and coarctation of the aorta

Turner syndrome (45,X) is classically associated with left-sided obstructive lesions, particularly bicuspid aortic valve (~30%) and coarctation of the aorta (~10-15%).