Atrial septal defect chest x ray


 * Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [mailto:psingh@perfuse.org]; ; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [mailto:kfeeney@perfuse.org]

Overview
Chest x rays may be used as a diagnostic tool in the evaluation of an atrial septal defect. As a modality, chest x rays can be limited in diagnostic imaging quality and may often be elected to be used in conjunction with other diagnostic modalities. The chest x-ray may show features suggesting cardiomegaly (right ventricular and right atrial enlargement), prominent pulmonary artery segment, and increased pulmonary vascular markings.

Common Findings
Findings on anteroposterior view of chest X-ray that may be seen in atrial septal defect are -

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