pediatrics
Aortopulmonary Window
Diagnosis of Aortopulmonary Window
Chest x-ray and ECG Echocardiography and sometimes CT or MR angiography Diagnosis is by physical examination findings, ECG, and imaging. The ECG demonstrates right ventricular hypertrophy or biventricular hypertrophy. The chest x-ray shows cardiomegaly, a large main pulmonary artery segment, and increased pulmonary vascular marking. Echocardiography usually demonstrates the defect, but the absence of the wall between the aorta and main pulmonary artery and proximal right pulmonary artery may be relatively subtle, and the etiology of the pulmonary hypertension may initially be obscure. When findings of pulmonary hypertension are noted without an obvious intracardiac defect, the proximal great vessels should be scanned to look for a defect between the aorta and main pulmonary artery near the pulmonary artery bifurcation and proximal right pulmonary artery. MR or CT imaging clearly defines the presence and extent of the defect. Cardiac angiography is rarely necessary, but in some instances may be helpful in clarifying the degree of shunting and pulmonary hypertension. 