Chest radiographs in PPHN commonly show?

• A. May be normal or show decreased pulmonary vasculature
• B. Lobar consolidation
• C. Large pleural effusions
• D. Cardiomegaly with edema

Answer: (A)

PPHN causes high pulmonary vascular resistance after birth, which leads to right-to-left shunting and reduced pulmonary blood flow. Because the problem is hemodynamic rather than primary lung infection or fluid overload, chest radiographs are often normal. When there are abnormalities, they typically show decreased pulmonary markings due to reduced perfusion (oligemia) rather than parenchymal consolidation. Large pleural effusions or lobar consolidation would point to other issues like effusion or infection, and cardiomegaly with edema suggests congestive changes rather than the usual isolated PPHN pattern. So the most characteristic radiographic description is a film that is normal or shows decreased pulmonary vasculature.