CXRAY AND ECHO CORRELATION

1. CXRAY AND ECHO
CORRELATES IN CHD
DR RAVI NARAYAN,MD DM
ASSOC. PROF AND SENIOR
CONSULTANT PEDIATIC CARDIOLGY
RAMAIAH NARAYANA HEART CENTRE

2. Introduction
 Congenital—means from birth
 Congenital heart defects (CHD)
can vary from small holes in
the heart to very serious
malformations

3. 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

4. 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

5. WHAT IS ECHO??
 ULTRASOUND OF
HEART.
 M MODE, 2D,
DOPPLER AND
COLOUR DOPPLER
 3 D
 TEE

6. Echocardiography
 Second Stethoscope
 * Exquisite
anatomy even in
neonates
•••Structure and
function
 More than 95% of
cases can be sent
for surgery without
cath.

7. ROUTINE CXRAY??
DO WE NEED CXRAY
FOR DX OF CHD??
DO WE NEED ECG
FOR DX OF CHD??

11. SEE LEFT HEART BORDER

27. Fluoroscopy showing ASD
device

28. PLAX and PSAX Views

29. 4C and Aortic(5C) View

30. ASD Device closure

31. PDA ductal cut

33. Large VSD

34. CXRAY—SHUNT LESIONS
• CARDIOMEGALY
• PLETHORA
• DILATED PA
• EISENMENGER---PRUNING
• (SMALL AND MODERATE LESIONS—CAN BE WITHIN
NORMAL LIMITS)

45. MRI TI WEIGHTED
SEQUENCE

46. TOF
• PLAX

47. Views
• PSAX

50. TEE VIDEO CLIP

51. 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