Differential Diagnosis for Boot Shaped Heart in X-ray
Single Most Likely Diagnosis
- Tetralogy of Fallot (TOF): This congenital heart defect is characterized by four main components, including ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta. The "boot-shaped" heart is a classic radiographic finding in TOF due to the right ventricular hypertrophy.
Other Likely Diagnoses
- Pulmonary Stenosis: Isolated pulmonary stenosis can also lead to right ventricular hypertrophy, which may result in a boot-shaped heart on X-ray, although it is less common than in TOF.
- Right Ventricular Hypertrophy (RVH) due to other causes: Any condition leading to RVH, such as pulmonary hypertension or other congenital heart diseases, could potentially cause a boot-shaped appearance on X-ray.
Do Not Miss Diagnoses
- Pulmonary Embolism with Pulmonary Hypertension: Although less common, a large pulmonary embolism can lead to acute right ventricular strain and potentially a boot-shaped heart on X-ray. Missing this diagnosis could be fatal.
- Eisenmenger Syndrome: A congenital heart defect with reversed or bidirectional shunt due to pulmonary hypertension, which can also lead to right ventricular hypertrophy and a boot-shaped heart.
Rare Diagnoses
- Uhl's Anomaly: A rare congenital heart disease characterized by a partial or total absence of the myocardium of the right ventricle, which can lead to a boot-shaped heart due to the compensatory hypertrophy of the remaining myocardium.
- Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC): A rare heart condition where the muscle in the right ventricle is replaced by fat and scar tissue, potentially leading to a boot-shaped heart on X-ray due to the structural changes in the right ventricle.