DailyDx: Fetus Presenting with Cardiomegaly

History: Our patient presented at 36 weeks gestation.  Ultrasound images show the fetus with cardiomegaly, a dilated right atrium and right ventricle with mild tricuspid regurgitation.

Fetal echo images 1 and 2 show tricuspid regurgitation.

Image 1

Image 2

Image 3
Four chamber view showing dilated right side chambers

The biparietal section reveals hydrocephalic dilatation of the lateral ventricles with a large midline aneurysmally dilated draining vein.

Image 4
BPD section reveals ventriculomegaly and dilated midline cystic structure.
 

There was also mild polyhydramnios.

What is your diagnosis?

The answer to our DailyDx:

  Vein of Galen malformation leading to cardiac failure.  View power Doppler images 5 and 6 showing the vein of Galen malformation.

Image 5

Image 6 3D power Doppler view showing vein of Galen malformation

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