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Diagnostic Planes of the Fetal Heart

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The 5-Chamber View

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This module transitions from the 4-chamber view to include the aortic root. Students will learn the clinical significance of the 5-chamber view in evaluating the left ventricular outflow tract and detecting ventricular septal defects (VSD) and aortic anomalies.

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1. According to AIUM (2013), which number diagnostic plane is the 5-chamber view?
2nd 3rd 4th 5th
2. How is the 5-chamber view obtained from the 4-chamber view?
Major lateral tilt Caudal angulation Minimal cranial inclination 90° rotation
3. In the 5-chamber view, what proportion of the thorax should the heart occupy?
One-third One-half Two-thirds Three-quarters
4. In levocardia, toward which side should the fetal cardiac apex point?
Right of midline Midline Left of midline Posterior
5. In a normal 5-chamber view, into which atrium does the foramen ovale flap open?
Right atrium Left atrium Both equally Neither — it should be closed
6. Which ventricle appears slightly smaller in the normal fetal 5-chamber view?
Left ventricle Right ventricle They are always equal The dominant ventricle varies by GA
7. Which ventricle forms the cardiac apex in the 5-chamber view?
Right ventricle Left ventricle Both contribute equally Depends on fetal lie
8. What septal finding must be confirmed in a normal 5-chamber view?
Intact atrial septum only Intact muscular interventricular septum only Intact muscular AND membranous interventricular septum No septal assessment is needed at this plane
9. From which ventricle must the aortic root originate in a normal 5-chamber view?
Right ventricle Left ventricle Either ventricle It overrides both ventricles normally
10. What is the critical anatomical continuity to verify between the aorta and the interventricular septum?
Posterior aortic wall with the IVS Anterior aortic wall with the IVS Aortic valve leaflets with the IVS No continuity is expected
11. Which anomaly is best identified using the 5-chamber view?
Coarctation of the aorta Transposition of the great arteries (TGA) Ventricular septal defect (VSD) involving the outflow tract Total anomalous pulmonary venous return (TAPVR)
12. Why is the 5-chamber view critical in the evaluation of the left ventricular outflow tract (LVOT)?
It visualizes the pulmonary artery and its branches. It confirms the connection between the left ventricle and the ascending aorta. It directly measures blood flow in the superior vena cava. It evaluates the position of the coronary arteries.
13. In the 5-chamber view, which imaging technique enhances visualization of blood flow through the outflow tract?
Grayscale imaging Power Doppler imaging Color Doppler imaging Spectral Doppler imaging
14. During the 5-chamber view, an abnormal connection between the left ventricle and the pulmonary artery is observed. This finding suggests:
Hypoplastic left heart syndrome (HLHS) Persistent truncus arteriosus Transposition of the great arteries (TGA) Tetralogy of Fallot