Radiology of neonatal heart disease

The diagnosis of heart disease in newborn infants presents numerous radiologic difficulties because of a variety of factors, including the frequent absence of specific radiographic signs, the confusing effects of parenchymal disease, and the difficulties encountered in identifying specific locations of chamber enlargement and even in distinguishing between arterial and venous plethora. Definitive anatomic diagnoses can only rarely be made from plain chest films. Nevertheless, with adequate clinical information, lesions can be assigned to pathophysiologic categories, permitting intelligent planning of subsequent diagnostic maneuvers. Echocardiographic evaluation permits investigation on internal cardiac architecture and motion, which is very useful in diagnosing not only congenital cardiac malformations but also extracardiac lesions such as patent ductus arteriosus and persistent neonatal pulmonary hypertension.