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The cardiac silhouette occupies 50–55% of the chest width on an anterior–posterior chest X-ray When assessing the cardiovascular system on a chest X-ray, the following must be noted: The size of the heart (small, normal, or large) The contours of the heart reflecting various cardiovascular components which can be enlarged, absent, or displaced The Pulmonary vascularity which can be diminished, normal, or increased Many newborn children appear to have cardiomegaly when in fact the thymus is contributing to the “cardio-thymic shadow”. The lateral view of CXR can separate this from true cardiomegaly. An enlarged heart coupled with an increase in pulmonary vascular markings can be indicative of left to right shunting such as with ASD, VSD, and PDA.

This section on roentgenology is intended to give only a brief outline of those principles that catheterizing cardiologists must know. The interested reader is directed to any of several excellent monographs on roentgenology [1–].

Tricuspid atresia is a rare disorder occurring in 1–3% of patients with congenital heart disease [1]. The question has been raised as to whether tricuspid atresia exists as a separate entity or whether it is a form of single ventricle [1–4]. We chose to regard tricuspid atresia as a separate entity which can be diagnosed by two dimensional echocardiography. In complex congenital heart disease, we favour describing the echocardiographic abnormalities in sequence. This approach can be extended to the echocardiographic diagnosis of tricuspid atresia.