A UNIQUE PRESENTATION OF HYPOPLASTIC LEFT HEART SYNDROME – A SERIES OF 2 CASE REPORTS

Background: Hypoplastic left heart syndrome (HLHS) is a critical congenital heart defect marked by underdevelopment of left-sided heart structures.With an incidence of about 1 in 10,000 live births,prenatal detection is challenging but crucial.This report presents two distinct cases of HLHS diagnosed via prenatal ultrasound during the second trimester,highlighting the unique variations in presentation and the challenges associated with early detection. Case Reports: This article details two cases of hypoplastic left heart syndrome (HLHS) identified through prenatal ultrasound in the second trimester.In Case 1, a 31-year-old woman at 21 weeks and 5 days gestation had an ultrasound showing a hypoplastic left atrium and ventricle,thick echogenic left ventricle walls,no mitral valve flow,and a very thin ascending aorta.Despite recommendations for a dedicated fetal echocardiogram,intrauterine fetal death occurred.In Case 2, a 26-year-old at 22 weeks gestation was found to have a small echogenic left ventricle, a reduced mitral valve orifice, and a capacious right ventricle and atria, along with a small interventricular septum defect. There was no significant reduction in aortic size, but HLHS was suggested. Follow-up also resulted in intrauterine fetal death. Conclusion:Ultrasound plays a crucial role in diagnosing and assessing hypoplastic left ventricle (HLHS) by detecting abnormalities at the 4-chamber view (4CV) level.Prenatal echocardiography,particularly between 18 and 22 weeks of gestation, is vital for planning postnatal care and interventions. Despite advances in diagnosis and treatment, HLHS remains a significant cause of neonatal cardiac mortality.Early detection through ultrasound is essential for improving treatment outcomes and survival rates.