What Is an Echogenic Focus?

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What Is an Echogenic Focus?

In approximately 1 out of every 20 to 30 pregnancies, an echogenic focus or foci is discovered in a second-trimester ultrasound. These bright spots seen in the heart are called echogenic intracardiac foci (multiple) or an echogenic intracardiac focus (singular), which is often shortened to EIF, a cardiac echogenic focus, or echogenic focus.

This condition is considered a normal variation and generally doesn’t affect the baby's heart or its functioning. On ultrasound, there might be one or more bright spots found, usually in the ventricles, which pump blood. It is not a heart defect and for the majority of instances in which this occurs, it poses no risk to the fetus.

While the EIF might disappear during the third trimester, many times it is still present on later ultrasounds. Follow-up imaging studies aren’t typically recommended unless other abnormalities are found on the ultrasound and/or the pregnancy is at higher risk for chromosomal anomalies. In fact, echogenic focus is found in 3% to 5% of normal pregnancies.

While finding these bright spots in the heart might seem scary, an echogenic focus is actually a pretty common finding on ultrasound, and most often, is not cause for concern.

Symptoms

EIF causes no symptoms for the fetus or pregnant person. As noted above, this condition doesn't affect the health or function of the baby's heart.

Causes

The exact cause of an EIF is not known. However, it is believed that the bright spot or spots show up because there is an excess of calcium in that area of the heart muscle. On an ultrasound, areas with more calcium tend to appear brighter. For example, teeth show up brightly as well.

An echogenic focus can occur in any pregnancy. However, the rates of EIF in pregnant people of Asian descent are significantly higher.

Remember that EIF is not harmful to your baby and it's nothing to feel badly about. Moreover, nothing you did or didn’t do caused the EIF.

Diagnosis and Further Testing

An echogenic focus on its own poses no health risk to the fetus, and when the baby is born, there are no risks to their health or cardiac functioning as a result of an EIF. It is considered a variation of normal heart anatomy and is not associated with any short- or long-term health problems.

However, EIF may be associated with a higher risk for chromosomal abnormalities, such as Down syndrome (also known as trisomy 21), if other abnormalities are found on the ultrasound, particularly for pregnant people of advanced age or who have other risk factors. For this reason, if there is an EIF, a more detailed scan of the anatomy may be performed.


If an EIF is the only notable finding on the ultrasound, it is considered an “isolated” finding and nothing to worry about. Additionally, the link between EIF and chromosomal abnormalities, if any, is still uncertain.

If you are concerned about Down syndrome or other possible atypical events, talk with your obstetrician or a genetic counselor. While there are no established follow-up tests for an EIF, there are various prenatal tests that are available to you, like amniocentesis. Your pregnancy care provider can discuss the risks and benefits of additional testing with you and answer any questions you may have.

The genetic counselor can also go over options for further testing and answer any questions about screening versus diagnostic prenatal tests, and what various test results might mean for the fetus. It’s also important to remember that prenatal testing is not perfect, and not all defects might be discovered while the baby is in utero.

Treatment

No treatment is required for this condition. The echogenic focus may go away on its own or it may not, but it doesn’t affect a child’s cardiac function so there is no need for treatment or even follow-up testing to see if it is still there.

A Word From Verywell

It can be frightening and confusing when you hear that something has been found on your baby’s ultrasound. Even if it’s considered normal, this can be scary. Know that in the vast majority of cases, an EIF is a benign anomaly. Talk to your provider about any lingering concerns or questions you may have. Pregnancy, for all its joys, can also bring stressors—and that’s OK. Just make sure you have people to lean on and talk with when you need some extra support.

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