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.