Differential Diagnosis for Boot Shaped Heart on CXR
Single Most Likely Diagnosis
- Tetralogy of Fallot: This congenital heart defect is characterized by four components, including ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and an overriding aorta. The "boot-shaped" heart is a classic radiographic finding due to the right ventricular hypertrophy.
Other Likely Diagnoses
- Pulmonary Stenosis: Isolated pulmonary stenosis can also lead to right ventricular hypertrophy, resulting in a similar radiographic appearance.
- Right Ventricular Hypertrophy (RVH) due to other causes: Conditions such as pulmonary hypertension or other congenital heart diseases can cause RVH, leading to a boot-shaped heart on CXR.
Do Not Miss Diagnoses
- Ebstein's Anomaly: Although less common, this congenital heart defect involves the tricuspid valve and can lead to significant right atrial enlargement and right ventricular hypoplasia, potentially mimicking a boot-shaped heart.
- Uhl's Anomaly: A rare condition characterized by near-total absence of the myocardium of the right ventricle, which can present with similar radiographic findings.
Rare Diagnoses
- Double Chambered Right Ventricle: A rare congenital anomaly where the right ventricle is divided into two chambers, potentially leading to right ventricular hypertrophy and a boot-shaped heart on CXR.
- Cardiac Tumors: Rarely, cardiac tumors such as rhabdomyomas or fibromas can cause localized hypertrophy or enlargement, potentially resulting in a boot-shaped appearance on CXR.