Patent ductus arteriosus chest x ray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Priyamvada Singh, M.B.B.S. [2], Cafer Zorkun, M.D., Ph.D. [3], Ramyar Ghandriz MD[4] Assistant Editor-In-Chief: Kristin Feeney, B.S. [5]

Overview

The findings on chest x ray depends on the degree of shunting between left and right system.

Chest X Ray

Small-Sized PDA

• Normal heart size and vascularity.

Medium-Sized PDA

• Occasionally, the ductus can be seen as a separate convexity between the aortic knob and the pulmonary artery segments.
• Cardiomegaly related to left atrium and left ventricular volume overloads.
• Increase in the pulmonary vascular markings.
• The ascending aorta may be prominent due to increased flow.

Large-Sized PDA

• Similar to a PDA complicated by pulmonary vascular disease.
• Left ventricular overload regresses by adolescence and the heart size may revert to normal.
• The apex may be tilted upward reflecting right ventricular hypertrophy.
• The pulmonary trunk and its branches are markedly dilated and may show central calcification, but in the outer third there is an abrupt decrease in vascularity.

Initial chest X-ray shows cardiomegaly. CT ratio was 0.59. Pulmonary edema in both lungs without pleural effusion can be seen (A). The patient's cardiomegaly and pulmonary edema show improvement after transcatheter closures of patent ductus arteriosus. CT ratio has decreased to 0.47 and symptoms related to heart failure improved without medical treatment including diuretics (B). Case courtesy by Hye Yeon Lee, MD et al