ABSTRACT

The heart develops in the cardiogenic region at the caudal end of the embryonic germ disc. Family history in first-degree relative is an indication for referral to a fetal cardiology unit for detailed scanning. Moderate lesions may show left ventricular hypertrophy on electrocardiography (ECG), cardiomegaly and plethoric lung fields on chest x-ray (CXR). Large Patent ductus arteriosus cause left atrial and left ventricular enlargement initially, with later right ventricular hypertrophy; ECG shows an increase in left-sided voltages and CXR demonstrates cardiomegaly and pulmonary plethora changes. Peripheral pulmonary artery stenosis is also seen as an iatrogenic consequence of cardiac surgery to the pulmonary arteries. The association of coarctation with other cardiac lesions also influences the clinical presentation of the patient. Cardiomegaly may be seen on CXR, and rib notching may be identified in the older child due to formation of collateral vessels. Fallot tetralogy is the most common cyanotic cardiac lesion and represents approximately 10% of all congenital heart defects.