Atrial Septal Defect X-ray Findings: What Shape Does the Cardiac Silhouette Take?

When evaluating atrial septal defect (ASD) through X-ray imaging, the cardiac silhouette often appears as a pear-shaped outline. This distinct appearance is primarily due to the enlargement of the right atrium and right ventricle, along with dilation of the pulmonary artery. In contrast, the aortic knob tends to appear smaller, further contributing to this characteristic shape.

Additional X-ray Features of Atrial Septal Defect

Aside from the classic pear-shaped heart, another key radiographic feature associated with ASD is pulmonary plethora. This condition is marked by increased pulmonary blood flow and is commonly observed in patients with left-to-right shunts caused by the defect.

Signs of Pulmonary Hypertension in X-ray Imaging

In more advanced cases, especially when severe pulmonary hypertension is present, additional X-ray findings may emerge. These include a prominent and elevated pulmonary artery segment, which appears as a protrusion in the pulmonary region of the heart. Moreover, the right lower pulmonary artery may appear significantly widened, indicating increased pressure and flow through the pulmonary circulation.