CXR showing dilated RVOT

RVOT

CXR showing dilated RVOT

Chest X-ray PA view showing a bulge along the left border, below the aortic knuckle and pulmonary bay. Sternal wires are seen near the midline, which would suggest that the person has possibly undergone a cardiac surgery by sternotomy. Bulge below the pulmonary bay can be due to several reasons: prominent left atrial appendage as in severe mitral stenosis, dilated right ventricular outflow tract as in ebstein’s anomaly or endomyocardial fibrosis, submitral left ventricular aneurysm, bulge due to partial absence of left pericardium or even a levoposed aorto in L-Transposition of great arteries. Dilated right ventricular outflow tract can occur in case of severe pulmonary regurgitation after repair of Tetralogy of Fallot with a trans annular patch.