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Journal ArticleDOI

Distinctive Mediastinal Appearance in Chest Radiograph of a Patient with Total Anomalous Pulmonary Venous Connection

01 Jan 2016-Vol. 1, Iss: 1, pp 1-3

TL;DR: This case of a 22-month-old boy who presented to the Emergency department with a history of intermittent fever and cough, initially diagnosed as pneumonia presents the “snowman” or “figure-of-eight” appearance characteristic of TAPVC, and the patient’s chest radiograph is suggestive of a well-defined, smooth and linear vascular shadow.

AbstractDespite technological advancements, diagnosis of total anomalous pulmonary venous connection (TAPVC) can be challenging in neonates and infants, particularly in asymptomatic cases. We report a case of a 22-month-old boy who presented to the Emergency department with a history of intermittent fever and cough, initially diagnosed as pneumonia. The presence of an enlarged mediastinal mass was noted in a chest radiograph and was interpreted as a potential malignancy. However, the presence of a supracardiac type of TAPVC with significant right-sided cardiac dilation and a large unobstructed ascending vertical vein was confirmed by echocardiogram. Elective and uneventful surgical correction was performed with subsequent follow-up to confirm cardiac stability and normalization. This case presents the “snowman” or “figure-of-eight” appearance characteristic of TAPVC. Moreover, our patient’s chest radiograph is suggestive of a well-defined, smooth and linear vascular shadow with the presence of a normal lung parenchyma along with increased pulmonary vascularity indicating a left-sided vertical vein in keeping with the supracardiac type of TAPVC. Not commonly reported in previous literature, these unique radiographic findings may hold significant value for pediatricians and imaging specialists as a diagnostic tool for the supracardiac variant of this congenital pathology

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References
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Journal ArticleDOI
TL;DR: Total anomalous pulmonary venous connection (TAPVC) is failure of development of the common pulmonary vein, with consequent ersistence and enlargement of embryonic collaterals between the lungs and the systemic veins.
Abstract: Total anomalous pulmonary venous connection (TAPVC) is failure of development of the common pulmonary vein, with consequent ersistence and enlargement of embryonic collaterals between the lungs and the systemic veins. In the great majority (91 of 93 autopsied cases, 97 per cent, no remnant of the common pulmonary vein was found, supporting the concept of agenesis or involution of the common pulmonary vein. Occasionally, a cordlike strand was found in the location of the common pulmonary vein (in three of 93 cases, 3 per cent), supporting the concept of atresia of the common pulmonry vein. The order of frequency of the various types of TAPVC was: left innominate vein ("snowman"), 26 perent cent; subdiaphragmatic, 24 per cent; coronary sinus, 18 per cent; right superior vena cava, 15 per cent; right atrium, 8 percent; mixed, 5 per cent; azygos, 2 per cent; and left supeior vena cava, 2 per cent...

192 citations


"Distinctive Mediastinal Appearance ..." refers background in this paper

  • ...It is a rare malformation of the heart in which the pulmonary veins (PV) carrying oxygenated blood drain directly into the deoxygenated systemic venous circulation rather than the left atrium (LA) [2]....

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Journal ArticleDOI
TL;DR: The diagnosis was based on angiocardiography and heart catheterization, but the conventional chest roentgenogram proved to be quite characteristic of both conditions and the relatively slight impairment of health is stressed.
Abstract: Clinical studies are presented in: (a) One case of partial anomalous pulmonary venous drainage (right common pulmonary vein into inferior vena cava), and (b) four cases of total abnormal pulmonary venous drainage (via "left vena cava" and left innominate vein into the superior vena cava on the right side). One of the latter four cases was verified on exploratory thoracotomy. The diagnosis was based on angiocardiography and heart catheterization, but the conventional chest roentgenogram proved to be quite characteristic of both conditions. The relatively slight impairment of health is stressed in the cases reported here.

94 citations


Book
01 Jan 1986
TL;DR: Development of the heart cardiac anatomy radiation safety classification and hemodynamics of congenital heart disease the plain film diagnosis of congenitals heart disease cardiac catheterization angiographic equipment angiography ultrasound.
Abstract: Development of the heart cardiac anatomy radiation safety classification and hemodynamics of congenital heart disease the plain film diagnosis of congenital heart disease cardiac catheterization angiographic equipment angiography ultrasound.

59 citations


Journal Article

54 citations


"Distinctive Mediastinal Appearance ..." refers background in this paper

  • ...This occurs in about 5% of all TAPVC patients [1]....

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  • ...Total anomalous pulmonary venous connection (TAPVC) occurs in approximately 2% of all children born with congenital heart defects [1]....

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  • ...Cases are frequently misdiagnosed as having respiratory tract infection or pulmonary disease [1]....

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