heart enlargement may be slight or even absent if the shunt is small. Usually though the cardiac contour is suggestive of left ventricular enlargement and mild enlargement of the left atrium.
invariably there is an abnormal appearance of the aortic arch and the main pulmonary artery:
generally a large aortic knuckle, or with flattening of the angle between the aortic knuckle and the main pulmonary artery
in adults with PDA there may be calcification of the ductus or the adjacent aorta.
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