Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 15 , ISSUE 2 ( April-June, 2021 ) > List of Articles


Ultrasonographic Evaluation of Embryonic Cardiac Development

Gwang J Kim

Keywords : Embryo, Heart, Ultrasound

Citation Information : Kim GJ. Ultrasonographic Evaluation of Embryonic Cardiac Development. Donald School J Ultrasound Obstet Gynecol 2021; 15 (2):124-133.

DOI: 10.5005/jp-journals-10009-1701

License: CC BY-NC 4.0

Published Online: 02-07-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


The heart is the first functional organ in the human embryo and starts to beat by 4 weeks of development. Recently, progressive advances in medical ultrasonography, especially high-frequency transvaginal ultrasonography and the color Doppler equipment allow access to the developing embryonic human heart. The anatomical and functional characteristics of the embryonic heart are different from those of the fetus and neonate. Embryo crown-rump-length (CRL) at 2 mm shows a discernible heartbeat. At this time, the embryonic heart is in the cardiac tube stage. Embryo CRL at 5 mm shows distinct differential movements of the ventricles and atria (13th Carnegie stage, 6+4/7 gestational weeks). At the 7th gestational weeks, an interventricular septum can be visualized in the embryonic heart. Although a heartbeat can be detected and gross cardiac structures are visualized early in gestation, visualization of some embryologically important intracardiac structures, such as the endocardial cushion, atrioventricular foramen, or atrioventricular valves are still limited, even with the latest high-end equipment. Cine function and color Doppler provide some valuable information about the morphology and function of the developing embryonic heart. For the evaluation of the embryonic heart using ultrasonography, keep the principle of “As Low As Reasonably Achievable” (ALARA) and the least use of color Doppler and pulsed Doppler.

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  1. Moorman A, Webb S, Brown NA, et al. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart 2003;89(7):806–814. DOI: 10.1136/heart.89.7.806.
  2. Anderson RH, Webb S, Brown NA, et al. Development of the heart: formation of the ventricular outflow tracts. Arterial valves, and intrapericardial arterial trunks. Heart 2003;89(9):1110–1118. DOI: 10.1136/heart.89.9.1110.
  3. Orts-Llorca F, Puertal FJ, Sobrdo J. The formation, septation and fate of the truncus arteriosus in man. J Anat 1982;134(Pt 1):41–56.
  4. Krishnan A, Samtani R, Dhanantwari P, et al. A detailed comparison of mouse and human cardiac development. Pediatr Res 2014;76(6):500–507. DOI: 10.1038/pr.2014.128.
  5. Arraez-Aybar LA, Turrero-Ngues A, Manrantos-Gamarra DG. Embryonic cardiac morphometry in carnegie stages 15-23, from the complutense university of Madrid Institute of Embryology Human Embryo Collection. Cells Tissues Organs 2008;187(3):211–220. DOI: 10.1159/000112212.
  6. Preeta D, Elaine L, Anita K, et al. Human cardiac development in the first trimester. A high-resolutin magnetic resonance imaging and episcopic fluorscence image capture atlas. Circulation 2009;120(4):343–351. DOI: 10.1161/CIRCULATIONAHA.108. 796698.
  7. Streeter GL. Developmental horizons in human embryos: description of age group XV, XVI, XVII, and XVIII, being the third issue of a survey of the Carnegie collection. Contrib Embryol Carnegie Inst, Washington 1948;32:133–203.
  8. Bran RP. The embryology of ventricular flow pathways in man. Circulation 1962;25(5):756–779. DOI: 10.1161/01.CIR.25. 5.756.
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