Frequent variations of normal heart anatomy: clinical significance and two dimensional echocardiographic diagnosis

General Medicine, 2025, 27(3), 54-61.

K. Vitliyanova

Department “Internal Diseases, Pharmacology and Clinical Pharmacology, Pediatrics, Epidemiology, Infectious and Skin Diseases”, Medical Faculty, Sofia University „Sv. Kliment Ohridski“

Abstract. The presence of anatomic variants of the normal cardiac anatomy is a commonly observed finding in echocardiographic examination. The instrumental evaluation of normal anatomic variants may be challenging and accompanied by diagnostic difficulties in clinical practice. Although each finding, normal-variant or pathologic, has a specific sonographic features, diagnosis requires a thorough knowledge of the patient specific clinical characteristics. The development of diagnostic imaging and three-dimensional echocardiography has facilitated differential diagnosis, but two-dimensional echocardiography remains the initial and leading diagnostic method. The material presents the main and frequently met in the clinical practice variants of the normal heart anatomy as well as its clinical significance and diagnosis. Knowledge of the discussed anatomical variations of normal cardiac anatomy is an important prerequisite for the correct interpretation of the results of echocardiographic examination and the basis for the acquisition of skills in echocardiographic method.

Key words: echocardiography, normal cardiac anatomy, variations

Address for correspondence: Assoc. Prof. Katerina Vitliyanova, e-mail: