Egg on a string

Case contributed by Subhan Iqbal
Diagnosis certain


Low saturation of oxygen, reluctant to feed

Patient Data

Age: 1 week
Gender: Male

The heart appears globular due to an abnormal convexity of the right atrial border and left atrial enlargement, therefore appearing egg-shaped.

Case Discussion

In transposition of the great arteries (TGA), frontal chest radiographs classically show cardiomegaly with the cardiac contours described as appearing like an egg on a string. There is often apparent narrowing of the superior mediastinum as the result of the aortic and pulmonary arterial configuration, i.e. parallel in D-loop transposition, with the main pulmonary artery posterior to the aorta. Findings were confirmed on echocardiography the following day.

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