Learning objectives
1.
To emphasize that chest X-ray (CXR) is still an important tool in evaluating heart disease in children.
2.
To describe normal anatomical features of the pediatric chest X-ray.
3.
To discuss chest X-ray findings in due course of congenital heart disease,
especially related to cardiac silhouette,
cardiac chambers and pulmonary vasculature.
Background
Despite developement of modern imaging methods CXR remains an essential component of diagnostic algorithmin pediatric cardiology.
CXR is a simple,
quick and cheap test that yields useful diagnostic information about heart,
lung perfusionandparenchyma,
abdominal situs,
and any bone anomalies that may be associated with heart defects [1].
Clinical symptoms in neonates with heart disorders are often non-specific.
In neonates suspected ofheart disease,
CXRis usually performed to rule out pulmonary disease as well as to evaluate pulmonary vasculature and cardiomegaly.
It is one of the first...
Findings and procedure details
1.
Anatomical features of pediatric chest X-ray
Systematic approach to interpreting pediatric chest radiographs is required.
Detailed understanding of normal contours of the cardiomediastinum is essential if abnormalities are to be detected,
as well as knowledge of the range of normal for pulmonary vasculature marking.
Decided majority of CXRs are taken with the newborn lying down.
In case of children in severe conditions,
examination is performed by the patient's bed; modern incubators are adapted for such endeavor.
Images are taken in anteroposterior projection,
without the...
Conclusion
Thorough knowledge of radiographic features in pediatric heart disease may facilitate the differential diagnosis and further selection of diagnostic and management plan.
References
References
1.
Knowles R,
Griebsch I,
Dezateux C,
Brown J,
Bull C,
Wren C.
Newborn screening for congenital heart defects: a systematic review and costeffectiveness analysis.
Health Technol Assess 2005;9:1-152,III-IV.
2.
Chang RK,
Gurvitz M,
Rodriguez S.
Missed diagnosis of critical congenital heart disease.
Arch Pediatr Adolesc Med 2008;162:969-74.
3.
Yee L.
Cardiac emergencies in the first year of life.
Emerg Med Clin North Am 2007;25:981-1008.
4.
Birkebaek,
NH,
Hansen,
LK,
Elle,
B,et al.
Chest roentgenogram in the evaluation of heart defects in asymptomatic infants...