Cardiac Interpretation of Pediatric Chest X-Ray

Abstract

The cardiac silhouette occupies 50–55% of the chest width on an anterior–posterior chest X-ray When assessing the cardiovascular system on a chest X-ray, the following must be noted: The size of the heart (small, normal, or large) The contours of the heart reflecting various cardiovascular components which can be enlarged, absent, or displaced The Pulmonary vascularity which can be diminished, normal, or increased Many newborn children appear to have cardiomegaly when in fact the thymus is contributing to the “cardio-thymic shadow”. The lateral view of CXR can separate this from true cardiomegaly. An enlarged heart coupled with an increase in pulmonary vascular markings can be indicative of left to right shunting such as with ASD, VSD, and PDA.