Atrial septal defect chest x ray

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [4]

Overview

Chest x rays may detect an atrial septal defect. Chest x rays can be limited in imaging quality and may only supplement other imaging modalities. The chest x-ray may demonstrate cardiomegaly (right ventricle and right atrial enlargement), a prominent pulmonary artery segment and increased pulmonary vascular markings.

Chest X Ray

Common Findings

CXR findings on an anteroposterior view of the chest x-ray in atrial septal defect may include: ^[1]

1) Prominent pulmonary artery, increased pulmonary vascular markings.

2) Cardiomegaly due to right atrial and ventricular enlargement.

3)’ Triangular appearance of the heart

Results from enlargement of pulmonary arteries preventing the ascending and transverse aorta from forming normal heart borders.

4) Scimitar sign

A vertical, modestly curved, density in the right-side of the pericardium, may be visible.
Commonly associated with the sinus venosus atrial septal defect.
Results from the point of insertion of the pulmonary vein into the inferior vena cava.
May cause abnormal densities within the chest x ray.

5) Dilatation of the superior vena cava can be seen in sinus venosus

Less Common Findings

Normal appearance of heart vasculature
Left heart enlargement/left atrial enlargement
Pulmonary edema
Pulmonary venous hypertension

Imagings

Enlarged right atrial border and mild cardiomegaly.
Lateral view
Post repair. Enlarged right atrial border and mild cardiomegaly.
Post repair. Lateral view.
ASD. Another patient. Enlarged right atrial border and advanced cardiomegaly.

References

↑ Abdulla, Ra-id. (2011). Heart Diseases in Children: A Pediatrician’s Guide. Springer.

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[Abdulla-1] Abdulla, Ra-id. (2011). Heart Diseases in Children: A Pediatrician’s Guide. Springer.

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