Presentation
History of progressive exertional dyspnea and episodes of cyanosis. Physical examination revealed a murmur. Electrocardiography demonstrated right bundle-branch block.
Patient Data



There is marked cardiomegaly with a huge right atrial margin and somewhat squared or box-shaped appearance.
The aorta and main pulmonary artery segment are not well delineated.
The visualized pulmonary vascularity is within normal to slightly decreased.



Annotated image showing the box-shaped heart.
Author: Vincent Tatco
License: CC-NC-BY-SA
Case Discussion
This case shows the radiographic appearance of the cardiac silhouette in an echocardiographically proven Ebstein anomaly.