Normal size left ventricle on antenatal scan in lethal hypoplastic left heart syndrome.

We present a case of lethal hypoplastic left heart syndrome missed at routine 20-week antenatal ultrasound examination because the left ventricle was of normal size on the standard four-chamber cardiac view. Hypoplastic left heart syndrome includes a spectrum of cardiac malformations. This case illustrates the difficulty in excluding the diagnosis of hypoplastic left heart syndrome on a single view from one antenatal second-trimester ultrasound examination.