This was a review scan of the same patient already posted here on 31 March  2013 – Left Atrial Isomerism . The review scan threw up some surprises . I was left wondering whether I should have got it the earlier time itself .

The first picture would confirm the left atrial isomerism – aorta and azygos vein seen side by side .

the four chamber view looked normal.

the LV Outflow tract view was more revealing . The IVS  is seen straddling the aorta .

the next few pictures show the straddling of the aorta by the inter ventricular septum.

the three vessel view shows a narrow pulmonary artery compared to the aorta with flow reversal

the A V Septal defect with the colour flow.

the diagnosis would be LEFT ATRIAL ISOMERISM WITH TETRALOGY OF F ALLOT

The irregular rhythm was not made out now.

Apart from this the fetus has symmetrical IUGR  and oligohydramnios

This brings out the importance of reviewing the patient at intervals.