Other Abnormalities

Increased thickness of the ventricular wall

  • Normal (bright spot of papillary muscle)
  • Right ventricular wall hypertrophy; commonly seen with volume overload or increased afterload
  • Cardiomyopathy
  • Cardiac tumor

Global cardiomegaly

  • Hydrops fetalis
  • High-output heart failure (chorioangioma, hemangioma)
  • Cardiomyopathy
  • Cardiac tumor (rhabdomyoma, teratoma)

Cardiac echogenic mass

  • Artifacts: echogenic papillary muscles of the heart
  • Rhabdomyoma (most common, accounting for 60%), often related to tuberous sclerosis
  • Teratoma (25%)
  • Fibroma (12%)
  • Myxoma (rare)
  • Hemangioma (rare)
  • Hamartoma (rare)

Pericardial hypoecho

  • Pericardial effusion
  • Pleural effusion
  • Normal: hypoechoic dropout

Cardiomegaly / Bradycardia:  Four-chamber view: generalized enlargement of the heart with pericardial effusion related to Hb Bart’s disease with bradycardia (arrowhead = spine)

Cardiomyopathy :  Marked cardiomegaly with thickening of the interventricular septum (IVS)

Cardiac rhabdomyoma:   Four-chamber view: echogenic mass (*) in the left ventricle (arrowhead = spine)

Small rhabdomyoma:  Small echogenic mass (5 mm) at the inner surface of the left ventricular wall

Coarctation of aorta:  Arch view at the upper thorax, extremely small aortic arch (arrow) compared to ductal arch (*) (arrowhead = spine)