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==Overview==
==Overview==
Although not the most preferred methodology, chest x rays may be used as a diagnostic tool in the evaluation of an atrial septal defect. Diagnostic findings may include enlargement of the atrial border or [[cardiomegaly]].
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 imaging techniques.  Typical findings may include [[cardiomegaly]] and pulmonary artery enlargement.


==Chest X-ray==
==Indications==
* Effectively evaluates the size of the heart
* Effectively evaluates the size of blood vessels involved with pulmonary hemodynamics


Findings of Chest X-ray seen in atrial septal defects are-
==Common Findings==
* In an anteroposterior view, one may see:
:* Prominent pulmonary vascular markings on the chest
:* Enlargement of the cardiac silhouette
:* Normal apperance of the left atrium and left ventricle
:* Triangular appearance of the heart
::* Results from enlargement of pulmonary arteries preventing the ascending and transverse aorta from forming normal heart borders
:* Visible fullness of the right atrium, likely the result of a moderate to large defect
:* [[Scimitar sign]], a vertical, gently curved, right-sided paracardiac density, 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
* In a lateral view, one may see:
:* Prominent pulmonary vasculature
::*Extends to the periphery of the lung fields and pulmonary trunk
::*Central branches may be dilated
::*Commonly found in '''ostium secundum''' atrial septal defects
* Both views may show [[pulmonary hyperemia]]


* In secundum ASD with large left-to-right shunt - Chest x-ray may show findings suggestive of cardiac enlargement and increased pulmonary vascularity. The increase in pulmonary vascularity typically extends to the periphery of the lung fields, and the pulmonary trunk and central branches appear dilated.
==Less Common Findings==
 
* Normal appereance of heart vasculature
* Triangular appearance of heart- This is seen because the enlarged pulmonary arteries prevents ascending and transverse aorta from forming the normal heart borders.
* Left heart enlargement/left atrial enlargement
 
* [[Pulmonary edema]]
* Enlargement of the right side of heart, however the left atrium and left ventricle are normal.
* Pulmonary venous hypertension
 
* Sinus venosus defect a scimitar sign may be seen. This occurs due to the insertion of the pulmonary vein into the inferior vena cava and can be appreciated as abnormal densities on the chest X-ray. The scimitar sign is a vertical, gently curved, right-sided paracardiac density.


==Disadvantages==
* Image quality is not comparable to that of other modalities such as echocardiography and ultrasound
* Appearance of defect signs may be subtle or absent in pediatrics and young adults


====Imaging====
====Imaging====
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[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Congenital heart disease]]
[[Category:Congenital heart disease]]
[[Category:Pediatrics]]
[[Category:Mature chapter]]
[[Category:Mature chapter]]


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Revision as of 18:43, 24 August 2011

Atrial Septal Defect Microchapters

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Ostium Secundum Atrial Septal Defect
Ostium Primum Atrial Septal Defect
Sinus Venosus Atrial Septal Defect
Coronary Sinus
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [[2]]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [[4]]

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 imaging techniques. Typical findings may include cardiomegaly and pulmonary artery enlargement.

Indications

  • Effectively evaluates the size of the heart
  • Effectively evaluates the size of blood vessels involved with pulmonary hemodynamics

Common Findings

  • In an anteroposterior view, one may see:
  • Prominent pulmonary vascular markings on the chest
  • Enlargement of the cardiac silhouette
  • Normal apperance of the left atrium and left ventricle
  • Triangular appearance of the heart
  • Results from enlargement of pulmonary arteries preventing the ascending and transverse aorta from forming normal heart borders
  • Visible fullness of the right atrium, likely the result of a moderate to large defect
  • Scimitar sign, a vertical, gently curved, right-sided paracardiac density, 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
  • In a lateral view, one may see:
  • Prominent pulmonary vasculature
  • Extends to the periphery of the lung fields and pulmonary trunk
  • Central branches may be dilated
  • Commonly found in ostium secundum atrial septal defects

Less Common Findings

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

Disadvantages

  • Image quality is not comparable to that of other modalities such as echocardiography and ultrasound
  • Appearance of defect signs may be subtle or absent in pediatrics and young adults

Imaging

References

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