X Ray Findings in Ventricular Septal Defect

Ventricular septal defect (VSD) can present with various X-ray findings depending on the size of the defect and the degree of left-to-right shunting. In cases where the VSD is small and the shunt is minimal, the X-ray appearance may closely resemble that of a healthy individual, with no significant abnormalities detected.

Cardiac Enlargement

One of the most common indicators of a moderate to large VSD is cardiac enlargement. Initially, this typically manifests as left ventricular enlargement due to increased volume load. As the condition progresses, right ventricular enlargement may also develop, and in advanced cases, global cardiac enlargement can occur.

Prominent Pulmonary Artery Segment

Another key feature visible on chest X-ray is a prominent pulmonary artery segment. This appears as a protrusion or bulging of the pulmonary artery contour on imaging, often due to pulmonary artery dilation. Increased pulmonary artery pressure can lead to signs of pulmonary congestion, including increased and disorganized pulmonary vascular markings or diffuse lung opacities.

Advanced Pulmonary Changes

If the condition worsens and progresses to Eisenmenger syndrome, significant changes may be observed. These include a decrease in heart size and characteristic vascular changes in the lungs known as "stump" or "pruned tree" signs. These findings are marked by enlarged central pulmonary arteries at the hilum with a marked reduction in peripheral vascular markings, resembling the branches of a dying tree.