The differential of an enlarged pulmonary trunk/main pulmonary artery on chest radiography includes:
- normal
- may appear prominent in young patients especially women
- projectional
- rotation of the heart
- pulmonary arterial hypertension (PAH)
- pulmonary embolism
- poststenotic dilatation
- increased pulmonary blood flow
- left to right shunt
- total anomalous pulmonary venous return (TAPVR)
- pregnancy
- high output cardiac failure
- Marfan syndrome
- idiopathic dilatation of the pulmonary trunk: diagnosis of exclusion
- mimics
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