Implications of an Echogenic Focus Found on Ultrasound

Doctor performing ultrasound scan on pregnant woman

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In This Article

During the second trimester of pregnancy, an ultrasound is done to examine the anatomy of the fetus. Often done between 18 and 20 weeks, this is usually also when you find out the biological sex of the fetus. Areas that are examined during the ultrasound include the limbs, skeleton, and internal organs, including the fetal heart.

The heart is made up of four chambers: the right atrium, the left atrium, the left ventricle, and the right ventricle. On ultrasound, there might be one or more bright spots found, usually in the ventricles, which pump blood. These bright spots are called echogenic intracardiac foci (multiple), or an echogenic intracardiac focus (singular), often shortened to EIF. You might also hear it referred to as a cardiac echogenic focus or echogenic focus.

While this might seem scary, this is actually a pretty common finding on ultrasound.

What Is an Echogenic Focus?

Approximately one out of every 20 to 30 pregnancies has an echogenic focus or foci on ultrasound. It is considered a normal variation and generally doesn’t affect the baby’s heart or its functioning. 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.


The exact cause of an EIF is not known.﻿﻿ The bright spot might show up because there is an excess of calcium in that area of the heart muscle, but this isn’t known for certain. On an ultrasound, areas with more calcium appear brighter, like your teeth.

Risk Factors

An echogenic focus can occur in any pregnancy. The rates of EIF in mothers of Asian descent are markedly higher (by about 30 percent).﻿﻿

The cause of EIF is unknown. Nothing the mother did or didn’t do caused the EIF, and it has nothing to do with a mother's age, health, lifestyle, or the number of pregnancies she's had.

Effect on the Fetus

An echogenic focus poses no health risk to the fetus, and when it is born, there are no risks to the baby’s health or cardiac functioning. It is considered a variation of normal heart anatomy and is not associated with any short or long-term health problems. If an EIF is the only notable finding on the ultrasound, it is considered an “isolated” finding and nothing to worry about.

If there are other abnormal findings, this may indicate another condition like Down syndrome (also known as trisomy 21). If there is an EIF, a more detailed scan of the anatomy may be performed. Generally, however, an EIF is considered a normal finding when it exists in isolation.﻿﻿

Further Testing

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 it might be worth seeking out a genetic counselor for another opinion and to discuss your concerns.

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.﻿﻿

A Word From Verywell

It can be frightening and stressful when you hear that something has been found on your baby’s ultrasound. Even if it’s considered normal, this can be scary. Talk to your provider about any lingering concerns, and seek support from your partner, trusted friends or family, or mom groups that you might already be a part of or seek to join in the future.

Pregnancy, for all its joys, can also bring stressors—and that’s okay. Just make sure you have people to lean on and talk with when you need some extra support.

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Article Sources
  1. Hamdan MA, El zoabi BA, Al shamsi A, Bekdache GN, Chedid F. Fetal echogenic cardiac foci: prospective postnatal electrocardiographic follow-up. J Perinatol. 2013;33(4):268-70. doi:10.1038/jp.2011.113

  2. Kaiser Permanente. Echogenic Intracardiac Focus (EIF).

  3. Shipp TD, Bromley B, Lieberman E, Benacerraf BR. The frequency of the detection of fetal echogenic intracardiac foci with respect to maternal race. Ultrasound Obstet Gynecol. 2000;15(6):460-2. doi:10.1046/j.1469-0705.2000.00138.x

  4. Shanks AL, Odibo AO, Gray DL. Echogenic Intracardiac Foci: Associated With Increased Risk for Fetal Trisomy 21 or Not? J Ultrasound Med. 2009; 28(12): 1639-43.

  5. Carlson LM, Vora NL. Prenatal Diagnosis: Screening and Diagnostic Tools. Obstet Gynecol Clin North Am. 2017;44(2):245-256. doi:10.1016/j.ogc.2017.02.004

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