Isolated Echogenic Intracardiac Focus (EIF)
An echogenic intracardiac focus, or EIF, is a tiny bright spot seen inside the baby's heart during an ultrasound.
It looks as bright as bone on the screen.
Isolated means it is the only finding after a detailed ultrasound.
An EIF is common and does not harm the baby. By itself, it is not a heart defect.
What causes the bright spot?
The bright spot may be caused by a tiny amount of calcium in a heart muscle or tendon.
It does not cause long-term heart problems for the baby.
How common is it?
EIF is seen in many healthy babies.
It may be more common in some families and ethnic groups.
Does EIF mean Down syndrome?
Most babies with an EIF do not have Down syndrome.
Your care team will look at your earlier screening results and the rest of the ultrasound.
What does SMFM recommend?
- if serum screening or cell-free DNA was low risk and EIF is the only finding, no more chromosome testing is needed just because of the EIF
- no special fetal heart ultrasound is needed just for an isolated EIF
- no follow-up ultrasound or special testing after birth is needed just for the EIF
What if I have not had screening?
Your care team may offer cell-free DNA or another screening test.
If other ultrasound findings are present, genetic counseling or more testing may be discussed.
What should I remember?
An isolated EIF with low-risk screening is considered a normal finding.
It usually does not need treatment before or after birth.
Medical references used for this handout
- Society for Maternal-Fetal Medicine. Consult Series #57: Evaluation and management of isolated soft ultrasound markers for aneuploidy in the second trimester. Reaffirmed 2025.
- American College of Obstetricians and Gynecologists. Current guidance on prenatal genetic screening and isolated soft ultrasound markers.
- Rodriguez R, Herrero B, Bartha JL. The continuing enigma of the fetal echogenic intracardiac focus in prenatal ultrasound. Curr Opin Obstet Gynecol. 2013;25(2):145-151.
- Wax JR, Donnelly J, Carpenter M, et al. Childhood cardiac function after prenatal diagnosis of intracardiac echogenic foci. J Ultrasound Med. 2003;22:783-787.