With the popularization of fetal systemic ultrasound examination in mid-pregnancy, pregnant women often come to the obstetrics clinic with the result of “strong left ventricular spot” described in the fetal systemic ultrasound report, and they are perplexed. In fact, “strong left ventricular spot” is professionally known as “strong echogenic spot in the ventricle”, which is an ultrasound image manifestation rather than a cardiac malformation, let alone an ultrasound diagnosis of fetal heart abnormalities. It is often seen in fetal heart ultrasound and is sometimes associated with fetal anomalies, so it often causes confusion. According to statistics, the incidence of fetal ultrasound showing strong echogenic spots in the ventricle at mid-term pregnancy (18-22 weeks) is 2.1%-5%, with some reports ranging from 0.5%-20%, so it is not surprising that “strong left ventricular spots” appear in the ultrasound report. Clinically, the left ventricle is more likely to show a strong echogenic spot than the right ventricle, and it can be seen in both ventricles (1.5%-7.6%); most cases show a single strong echogenic spot, while a few have two or three strong echogenic spots. They are usually between 1-6 mm in diameter and are located near the papillary muscles or tendons. As the gestational months increase, most of the strong echogenic dots gradually become indistinct, shrink, or even disappear. In a few cases, they persist until delivery and can be observed on ultrasound even after delivery. In the vast majority of fetuses, intraventricular dots may not be clinically significant, in other words, they do not necessarily represent an abnormality. However, in some cases, in addition to the presence of intracardiac spots, other intra- or extracardiac abnormalities have been found, such as soft indicators (thickening of the nuchal translucency NT, enhanced intestinal echogenicity, absence of nasal bone, etc.), various congenital heart disease manifestations, cervical hydatid tumor, ventricular dilatation, cerebral dilatation, renal pelvis dilatation, fetal growth retardation, finger/toe abnormalities, etc. Some of these abnormalities are also present Chromosomal abnormalities. The prevalence of chromosomal abnormalities in intraventricular echogenicity is about 1-5%. The overall chance of a combination of fetal anomalies in intracardiac strong echogenic points is 20%-24%, including chromosomal anomalies alone without body structure anomalies (4%-19%), chromosomal anomalies combined with body structure anomalies (17%-19%) and chromosomal normal anomalies with body structure anomalies (63%-78%). Intracardiac strong echogenic spots are more easily detected. Combining the incidence of fetal anomalies suggested by the above data, it can give us a hint that strong intracardiac echoes alone generally have no special significance, but if two or more factors are combined with abnormalities, we should follow the doctor’s advice to further test fetal karyotype to exclude fetal chromosomal abnormalities, especially for pregnant women of advanced age and poor maternal history, we should be more alert.