A radiographic and echocardiographic approach to cyanotic congenital heart disease.

An updated, systematic approach to the diagnosis of cyanosis in the infant or child has been presented. It involves the use of clinical data (to establish the presence of cyanosis), radiographic information (to assess lung parenchyma, pulmonary vascularity, and certain key, border-forming, cardiac structures), and M-mode and cross-sectional echocardiographic data (the source of detailed intracardiac anatomic information). Specific radiographic and echocardiographic features of the 10 most common cyanotic congenital heart lesions have been presented. Using this approach, one should be able to diagnose accurately the cyanotic infant or child. Further planning for cardiac catheterization and angiocardiography can then be accomplished with an informed and rational point of view.