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.

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

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

Cardiology