DEVELOPMENT OF SEVERE AORTIC-STENOSIS AND LEFT-VENTRICULAR DYSFUNCTION WITH ENDOCARDIAL FIBROELASTOSIS IN A 2ND TRIMESTER FETUS

The majority of significant cardiovascular lesions in the fetus develo p within the first trimester and presumably are present at the time of most second trimester ultrasonographic examinations. A few lesions ca n evolve, however, through the second and third trimesters.(1-5) One o f the more important defects that has the potential for significant ch ange in cardiac pathology is severe left ventricular outflow tract obs truction associated with left ventricular dysfunction and endocardial fibroelastosis. This constellation of findings has been associated wit h subsequent abnormal left heart growth and development of significant left heart hypoplasia.(6-9) We describe a case in which there is deve lopment of left ventricular dysfunction and endocardial fibroelastosis associated with severe aortic outflow tract obstruction over an 8 wee k period in a fetus with a normal cardiac examination at 17 weeks of g estation.