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Dystrophic calcification within fetal myocardium: a case report
Author(s) -
Rowlands S. L.,
Sampson A. J.,
Kahler S.
Publication year - 2001
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2001.0180s1056.x
Subject(s) - medicine , autopsy , interventricular septum , calcification , echogenicity , fetus , pregnancy , gestation , cardiology , pathology , ultrasound , radiology , ventricle , genetics , biology
A woman presented at 19 weeks gestation for a second opinion of an echogenic cardiac focus. The pregnancy had been complicated by 2 episodes of first trimester vaginal bleeding. She had no significant personal or family medical history. The ultrasound reported a viable fetus with biometry equivalent to 19 weeks gestation. Morphological examination revealed an anatomically normal heart, but there were multiple echogenic foci present within the myocardium. These ranged in size from 2 to 6 mm, and were within both ventricular walls and the interventricular septum. There were no abnormalities of cardiac blood flow. The remaining morphology was normal, the amniotic fluid volume was appropriate and the fetus was active. Rhabdomyomata were thought to be the likely diagnosis. Their association with tuberous sclerosis was discussed and the couple elected to terminate the pregnancy. Postmortem examination showed these echogenic foci to be multiple areas of dystrophic calcification. These were isolated findings. There were no features of rhabdomyomata. Dystrophic calcification within the fetal myocardium has rarely been reported at autopsy. It is thought to represent sites of injury to the myocardium. There are few previous reports of its antenatal detection on ultrasound later confirmed at autopsy and, although reported in fetuses which are stillborn or miscarried, it is rarely otherwise seen (Veldtman et al . Heart 1999; 81: 92–93). Although generalized ischemia can lead to myocardial calcification in older individuals, the present case and those reported by Veldtman et al . do not show evidence of this. The extent of the myocardial calcification suggests that there would have been significant cardiac dysfunction if the pregnancy had progressed. However, we are unaware of cases in which the pregnancy has continued. This report will discuss the appearance, etiology and prognosis of dystrophic calcification of the fetal myocardium and the importance of differentiating it from rhabdomyoma on ultrasound.