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Dr. Andrew Rynne

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What does a mass in the left ventricle in normal interventricular septum indicate?

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Dr. Diptanshu Das

Pediatrician

Practicing since :2005

Answered : 3630 Questions

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Posted on Mon, 23 Apr 2018 in Congenital Heart Disease
Question: What does this mean? It was on my ultrasound report FINDINGS: The heart is diffusely abnormal. There is an apparent mass involving the left ventricle in normal interventricular septum is not seen mass in the left ventricle measures 5.9 x 6.3 mm patient may have a monoventricle. In addition no normal intra-atrial septum is seen.
doctor
Answered by Dr. Diptanshu Das 21 minutes later
Brief Answer:
Please upload the report.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through your query and understand your concerns. The mentioned details need to be corroborated. Could you please upload the entire report? I would also need to know the complaints for which medical attention was sought.

I understand that the septum between the left and right atria is missing. But is the interventricular septum missing too (in order to make it a monoventricle). Will be able to comment further after you upload the full report.

I would await your response. Let me know if I could help further.

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Diptanshu Das 1 hour later
Date of Service: 11-20-2017

Addendum 1

The heart demonstrates findings that are most consistent with a monoventricle, in this case a mono right ventricle, with probable double outlet right ventricle

There is no atrial septum seen and no definite intact ventricular septum seen.

The patient's attending Dr. Yasser Rattl Mrad was contacted at 9:00 AM on 11/21/2017 and told of these findings personally by EF Barasch and of the recommendation to refer the patient to a major pediatric center such as Loma XXXXXXX Los Angeles Children's or Fresno/Valley children's for further evaluation of the fetus.
End of addendum for accession: 0000
Dictated:
11-21-2017 9:28:37 AM
Dictated By:
Barasch, XXXXXXX MD
Signed By:
Barasch, XXXXXXX MD 11-21-2017 9:28:37 AM
Original Report
EXAM: ULTRASOUND OBSTETRICAL GREATER THAN 14 WEEKS

HISTORY: 27-year-old female known to be pregnant for size and dates

TECHNIQUE: Sonographic imaging was performed utilizing transabdominal approach.

COMPARISON: None available.

FINDINGS: The heart is diffusely abnormal. There is an apparent mass involving the left ventricle in normal interventricular septum is not seen mass in the left ventricle measures 5.9 x 6.3 mm patient may have a monoventricle. In addition no normal intra-atrial septum is seen.

In the remainder of the study:

Closed cervical neck measures 3.6 cm in length. The placenta is anterior with no evidence of placenta previa the fetus is is transverse lie

Lower extremities are seen. The femur measures 2.98 cm. Fetus moves into breech position during this study. The normal stomach bubble. Abdominal circumference = 15.22 cm cerebella measures 2.1 cm transversely

Amniotic fluid index = 13.72 cm deepest pocket = 4.23 cm

Gestational age by today's findings is 19 weeks and 6 days +/- 10 days estimated date of delivery 4/10/2018

Estimated fetal weight = 312.5 g +/- 40 7 g or 11 ounces +/- 2 ounces.

Estimated fetal weight percentile = 11.5%. Her graft fetal heart rate = 146

Cephalic index = 75.03.

FL/AC = 19.03.

FL/HC = 16.56 which is slightly lower than normal 16.7.

HC/AC = 1.15.

IMPRESSION: Single live intrauterine pregnancy with an estimated ultrasound age of 19 weeks 6 days. +/- 10 days.

The heart is diffusely abnormal. There may be a mass involving the left ventricle wall. Normal intraventricular septum is not seen. Normal arterial septum is not seen.
End of diagnostic report for accession: 0000
Dictated:
11-20-2017 5:43:58 PM
Dictated By:
Barasch, XXXXXXX MD
Signed By:
Barasch, XXXXXXX MD 11-20-2017 5:43:58 PM
Confidential

This is the report I have
doctor
Answered by Dr. Diptanshu Das 8 hours later
Brief Answer:
Serious heart condition.

Detailed Answer:
Thanks for the update. This is indeed a serious heart ailment in an unborn fetus and even if delivered, life would not be easy. Termination of pregnancy needs to be considered and a detailed discussion about the possible outcomes needs to be done with her obstetrician or fetal medicine specialist.

Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
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