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Cardiac imaging has come a long way. Currently, excellent diagnostic images of most cardiac malformations can be obtained by US, MSCT, MRI or nuclear medicine.
Despite the many advantages of modern technology, it should be remembered that, not so long ago, we were able to obtain significant information by a careful examination of plain films. A large number of correct diagnoses could be made by combining plain film features with clinical information and EKG findings. Thus, in cyanotic babies, a right aortic arch would suggest either tetralogy of Fallot or truncus arteriosus. While the former usually presents with decreased pulmonary vascularity and normal-sized heart, the latter presents with cardiomegaly and increased pulmonary circulation.