Features that are recognizable on a chest x-ray may be used in various ways to assist in the diagnosis and evaluation of congenital heart disease. The sizes and shapes of the major arteries and heart chambers and the degree of lung ventilation may usually be readily determined.

Some specific features that may indicate the presence of CHD are given below:

• Heart size
• Heart shape
• Pulmonary vascular markings - increased or decreased
• Pulmonary edema - presence or absence
• Degree of lung inflation
• Dilatation of heart chambers
• Notching of ribs
• Distinctive patterns in the lung fields (e.g. haziness or reticulogranularity)