Paeds: Vascular Chest

Playlist contributed by: Dr Annabelle Skelley

Acyanotic Congenital Heart Disease

Pulmonary plethora:

  1. VSD
  2. ASD
  3. AVSD
  4. PDA

Normal pulmonary vascularity:

  1. Aortic valve stenosis
  2. Aortic coarctation
    • Rib notching & figure of 3 sign
  3. Pulmonary stenosis 
    • Prominent main pulmonary artery but normal peripheral pulmonary arteries

Cyanotic Congenital Heart Disease

Pulmonary plethora (increased pulmonary vascularity):

  1. TAPVR
    • Prominent right heart, normal LA
  2. Transposition of the great arteries
    • Most common
    • ‘Egg on a string’ -> apparent narrowing of superior mediastinum
  3. Truncus arteriosis
    • Association with right-sided arch
    • Can have small main pulmonary artery
  4. Large AVSD

Decreased pulmonary vascularity:

  1. Tetralogy of Fallot
    • Boot shaped heart -> elevation of cardiac apex
    • Pulmonary oligaemia
    • Can have right sided aortic arch
    1. VSD
    2. RVOT obstruction
    3. Overriding aorta
    4. Ventricular hypertrophy
  2. Pentalogy of Cantrell (very rare)
  3. Ebstein anomaly with ASSD
  • Severe right-sided cardiomegaly
  • Box-shaped heart


Playlist information

rID: 20684
Visibility: public

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