Cxr In Congenital Heart Disease

Front 1

State the systematic features to look for on a CXR for a child with suspected congetial heart disease?

Back 1

1) Name, date and side marker.
2) Cardiac size and contour, look for specific chamber enlargement..
3) Mediastinal structures.
4) Aortic arch side and size.
5) Lung size, aeration, central and peripheral vascularity, including symmetry.
6) Others: abdominal situs, bones (11 pairs of ribs = Trisomy 21 with increased risk of AV canal, tetralogy etc.).

Front 2

What are the progressive stages of pulmonary plethora seen on a CXR?

Back 2

1) Enlargement of the central and peripheral pulmonary arteries
2) Interstitial oedema
3) Frank pulmonary oedema

Front 3

What lesion(s) might cause a very large heart with a small degree of pulmonary plethora?

Back 3

A left to right shunt with a left sided obstructive lesion (most commonly a VSD and CoA)

Front 4

What are the 3 most common causes of left to right shunt? And how can these be distinguished on CXR?

Back 4

1) ASD - right heart enlargement, (no left atrial enlargement)
2) PDA - enlarged aortic arch (in older children)
3) VSD - left heart enlargement