Cyanotic heart defect chest x ray

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-In-Chief: Keri Shafer, M.D. [2], Atif Mohammad, M.D.; Kalsang Dolma, M.B.B.S.[3]

Overview

A chest radiograph is helpful in differentiating between cardiac and pulmonary disorders.

Heart Shape and size –

Patients with left-sided obstructive lesions may have cardiomegaly due to heart failure.
Tetralogy of Fallot – Boot-shaped (coeur en sabot) heart.
D-transposition of the great arteries – Egg-on-a-string pattern caused by a narrow mediastinal shadow produced by the anterior-posterior rather than right-left relationship of the great arteries.
Total anomalous pulmonary venous connection-A large supracardiac shadow due to anomalous pulmonary vein and persistent left superior vena cava can be seen, which together with normal cardiac shadow forms a snowman appearance.

Pulmonary vascular markings —

The pattern of pulmonary blood flow depends upon the specific cardiac lesion.
Decreased pulmonary vascular markings occur in most cyanotic CHD lesions
Increased pulmonary vascular markings occur in patients with truncus arteriosus or mixing lesions, such as common atrioventricular canal, as pulmonary vascular resistance falls after delivery.