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CXRAY AND ECHO
CORRELATES IN CHD
DR RAVI NARAYAN,MD DM
ASSOC. PROF AND SENIOR
CONSULTANT PEDIATIC CARDIOLGY
RAMAIAH NARAYANA HEART CENTRE
Introduction
 Congenital—means from birth
 Congenital heart defects (CHD)
can vary from small holes in
the heart to very serious
malformations
How big is the problem
??
 CHD—1/1000 live births
 India---180,000 babies/year
 Estimated 40-50,000/year will have
shunt lesions(“Holes in heart”)
 Easy to diagnose
 Reasonably easy to treat unlike
complex heart disease
Classification
 ACYANOTIC
 Holes in heart --
ASD,VSD,PDA
 Narrow Valves --
AS, PS, MS
 Narrow pipe --
COA of aorta
 Weak muscle --
EFE/ DCM
 CYANOTIC
 5T’s–
TOF,TGA,TRUNCUS,
TAPVC, TR.
ATRESIA
 2 E’S –EBSTEIN
EISENMENGER
 2 SINGLES –
SINGLE A,
 SINGLE V
WHAT IS ECHO??
 ULTRASOUND OF
HEART.
 M MODE, 2D,
DOPPLER AND
COLOUR DOPPLER
 3 D
 TEE
Echocardiography
 Second Stethoscope
 * Exquisite
anatomy even in
neonates
•••Structure and
function
 More than 95% of
cases can be sent
for surgery without
cath.
ROUTINE CXRAY??
DO WE NEED CXRAY
FOR DX OF CHD??
DO WE NEED ECG
FOR DX OF CHD??
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
SEE LEFT HEART BORDER
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Fluoroscopy showing ASD
device
PLAX and PSAX Views
4C and Aortic(5C) View
ASD Device closure
PDA ductal cut
Cxray and echo correlates in chd
Large VSD
CXRAY—SHUNT LESIONS
• CARDIOMEGALY
• PLETHORA
• DILATED PA
• EISENMENGER---PRUNING
• (SMALL AND MODERATE LESIONS—CAN BE WITHIN
NORMAL LIMITS)
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
Cxray and echo correlates in chd
MRI TI WEIGHTED
SEQUENCE
TOF
• PLAX
Views
• PSAX
Cxray and echo correlates in chd
Cxray and echo correlates in chd
TEE VIDEO CLIP
IS CXRAY BECOMING
UNNECESSARY??
 As a diagnostic tool for CHD, yes
 Cardiomegaly, especially in infants is
overdiagnosed
 Lung vascularity– yes
 To rule out lung pathology
 Post op period
 Situs– dextrocardia, mesocardia,
dextroversion
Cxray and echo correlates in chd
Cxray and echo correlates in chd

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Cxray and echo correlates in chd