What physical finding is characteristic of TAPVR on chest X-ray?

The characteristic chest X-ray finding associated with Total Anomalous Pulmonary Venous Return (TAPVR) is the "snowman sign." This sign refers to the appearance of the heart and great vessels on the radiograph, particularly in supracardiac varieties of TAPVR. The heart can appear as a figure resembling a snowman due to the abnormal configuration of pulmonary veins that return to the systemic circulation rather than connecting normally to the left atrium. This abnormality can lead to enlarged right heart structures and increased vascular markings due to congestion.

Recognizing the "snowman sign" is crucial for diagnosis, as it helps differentiate TAPVR from other congenital heart defects, enabling timely intervention and management for affected infants. The understanding of this radiographic finding is essential for neonatal nurses and practitioners dealing with congenital heart diseases in the NICU setting.