Cardiomegaly chest x ray: Difference between revisions
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{{CMG}}; {{AE}} {{CZ}} | {{CMG}}; {{AE}} {{CZ}} | ||
==Overview== | |||
Cardiomegaly is easily visualized on chest x ray. Cardiomegaly is traditionally defined as a [[cardiothoracic ratio]] that is more than 0.5 on a PA film. Other findings on chest x ray can help to determine the specific chamber that is contributing most to the enlargement of the heart. | |||
==Chest X Ray== | ==Chest X Ray== | ||
*Cardiomegaly is traditionally defined as an increase in the [[cardiothoracic ratio]] to be > 0.5 on a PA film. To calculate the thoracic ratio, the width of the cardiac silhouette is divided by the width of the entire thoracic cage. | *Cardiomegaly is traditionally defined as an increase in the [[cardiothoracic ratio]] to be > 0.5 on a PA film. To calculate the thoracic ratio, the width of the cardiac silhouette is divided by the width of the entire thoracic cage. | ||
*If the heart is viewed on an AP film, the heart can appear to be artificially enlarged because the X ray beam moves from anterior to posterior direction and therefore the heart which lies anterior is magnified. | *If the heart is viewed on an AP film, the heart can appear to be artificially enlarged because the X ray beam moves from anterior to posterior direction and therefore the heart which lies anterior is magnified. | ||
*:* Postero Anterior (PA) Projection: The adult heart is 12 cm from base to apex and 8-9 cm in transverse direction. | *:* Postero Anterior (PA) Projection: The adult heart is 12 cm from base to apex and 8-9 cm in transverse direction. | ||
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====X-ray Findings for Left Ventricular Enlargement==== | ====X-ray Findings for Left Ventricular Enlargement==== | ||
*Left heart border is displaced leftward, inferiorly, or posteriorly | *Left heart border is displaced leftward, inferiorly, or posteriorly | ||
*Rounding of the [[cardiac apex]] | *Rounding of the [[cardiac apex]] | ||
[[image:cardiomegaly-2.jpg|left|300px|thumb|Cardiomegaly. <br> Image courtesy of C. Michael Gibson MS. MD ]] | [[image:cardiomegaly-2.jpg|left|300px|thumb|Cardiomegaly. <br> Image courtesy of C. Michael Gibson MS. MD ]] | ||
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*Double density sign: Occur when the right side of the left atrium pushes into the adjacent lung. | *Double density sign: Occur when the right side of the left atrium pushes into the adjacent lung. | ||
*Convex left atria appendage: usually reflect prior [[rheumatic heart disease]]. | *Convex left atria appendage: usually reflect prior [[rheumatic heart disease]]. | ||
*Splaying of the [[carina]] | *Splaying of the [[carina]] | ||
*Posterior displacement of the [[left main stem bronchus]] on lateral radiograph | *Posterior displacement of the [[left main stem bronchus]] on lateral radiograph | ||
*Superior displacement of the [[left main stem bronchus]] on frontal view | *Superior displacement of the [[left main stem bronchus]] on frontal view | ||
*Posterior displacement of a barium filled [[esophagus]] | *Posterior displacement of a barium filled [[esophagus]] | ||
[[Image:Left-atrial-enlargement-001.jpg|left|300px|thumb|Double density sign]] | [[Image:Left-atrial-enlargement-001.jpg|left|300px|thumb|Double density sign]] | ||
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*Frontal view | *Frontal view | ||
:*Rounded left heart border | :*Rounded left heart border | ||
:*Uplifted apex | :*Uplifted apex | ||
*Lateral view | *Lateral view | ||
:*Filling of the retrosternal space | :*Filling of the retrosternal space | ||
:*Rotation of the heart posteriorly | :*Rotation of the heart posteriorly | ||
====X-ray Findings for Right Atrial Enlargement==== | ====X-ray Findings for Right Atrial Enlargement==== | ||
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[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 04:06, 9 August 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Cardiomegaly is easily visualized on chest x ray. Cardiomegaly is traditionally defined as a cardiothoracic ratio that is more than 0.5 on a PA film. Other findings on chest x ray can help to determine the specific chamber that is contributing most to the enlargement of the heart.
Chest X Ray
- Cardiomegaly is traditionally defined as an increase in the cardiothoracic ratio to be > 0.5 on a PA film. To calculate the thoracic ratio, the width of the cardiac silhouette is divided by the width of the entire thoracic cage.
- If the heart is viewed on an AP film, the heart can appear to be artificially enlarged because the X ray beam moves from anterior to posterior direction and therefore the heart which lies anterior is magnified.
- Postero Anterior (PA) Projection: The adult heart is 12 cm from base to apex and 8-9 cm in transverse direction.
- Lateral Projection: The adult heart is 6 cm in the antero posterior (AP) direction.
X-ray Findings for Left Ventricular Enlargement
- Left heart border is displaced leftward, inferiorly, or posteriorly
- Rounding of the cardiac apex
Image courtesy of C. Michael Gibson MS. MD
X-ray Findings for Left Atrial Enlargement
- Double density sign: Occur when the right side of the left atrium pushes into the adjacent lung.
- Convex left atria appendage: usually reflect prior rheumatic heart disease.
- Splaying of the carina
- Posterior displacement of the left main stem bronchus on lateral radiograph
- Superior displacement of the left main stem bronchus on frontal view
- Posterior displacement of a barium filled esophagus
X-ray Findings for Right Ventricular Enlargement
- Frontal view
- Rounded left heart border
- Uplifted apex
- Lateral view
- Filling of the retrosternal space
- Rotation of the heart posteriorly
X-ray Findings for Right Atrial Enlargement
- On a frontal view, the right atrium is visible because of its interface with the right middle lobe.
- Subtle and moderate right atrial enlargement is not accurately determined on plain films because there is normal variability in the shape of the right atrium.