Bundle branch block (BBB) is impossible to diagnose in a fetus with conventional fetal echocardiography. Isolated left BBB is rare in the neonatal period. Asymmetric left ventricular remodeling in isolated left BBB is secondary to chronic dyschronous activation and relaxation, resulting in thinning of the interventricular septum (IVS). This report describes a case of possible ventricular septal defect diagnosed at 34 weeks of gestation due to significant dropout in the outflow portion of the IVS seen in multiple views secondary to undiagnosed isolated left BBB in a fetus, with postnatal follow-up evaluation.
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Electronic supplementary material
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a, b Fetal echocardiography showing angled left ventricular outflow tract views with significant dropout in outflow portion of IVS without evident shunt on color Doppler. (AVI 12831 kb)
a, b Postnatal echocardiography showing rocking regional motion abnormality of left ventricle in parasternal short axis view and thin outflow portion of IVS with paradoxical motion in four chamber view (AVI 25635 kb)
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Sharma, J., Inglis, S., Predanic, M. et al. Isolated Left Bundle Branch Block Mimicking Outflow Ventricular Septal Defect in a Fetus. Pediatr Cardiol 30, 1026–1029 (2009). https://doi.org/10.1007/s00246-009-9484-4
- Bundle branch block
- Fetal echocardiography
- Ventricular septal defect