X-RAY: Pulmonary oligemia due to Ebstein's anomaly (downward displacement of the tricuspid value). PA chest film. Pulmonary oligemia due to large shunt through ASD and decrease blood flow into pulmonary arteries. Shows decrease in size of all pulmonary arteries with small hilar shadows, thin and scantly lung markings, making the lungs more lucent. Gross enlargement of the heart with relatively small aortic arch are also signs of Ebstein's anomaly.