Type:
Educational Exhibit
Keywords:
Cardiac, Anatomy, Paediatric, Conventional radiography, Education, Education and training
Authors:
K. Markiet, M. Stankowska, E. Szurowska; Gdansk/PL
DOI:
10.1594/ecr2018/C-2024
Background
Despite developement of modern imaging methods CXR remains an essential component of diagnostic algorithm in pediatric cardiology.
CXR is a simple,
quick and cheap test that yields useful diagnostic information about heart,
lung perfusion and parenchyma,
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 of heart disease,
CXR is usually performed to rule out pulmonary disease as well as to evaluate pulmonary vasculature and cardiomegaly.
It is one of the first examinations performed in newborns admitted to intensive care units.
Most of patients with congenital heart disease (CHD) that need early intervention present with no specific findings in CXR - figure 1. In most instances a definite diagnosis cannot be made,
however the differential can be narrowed down to a few likely diagnoses [2-5].
In this educational exhibit,
we will review various selected patterns of the pulmonary vasculature and focus on the silhouette of the heart as well as specific patterns recognized in chest X-ray in patients with congenital heart disease such as „figure of three” in aortic coarctation,
“egg on a string pattern” in transposition of the great arteries,
“snowman sign” in total anomalous pulmonary venous connection,
“boot-shaped heart” in tetralogy of Fallot,
and “box-shaped heart” appearance in the Ebstein anomaly.