Cardiomegaly chest x ray: Difference between revisions

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*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: adult heart is 12 cm from base to apex and 8-9 cm in transverse direction
*:* Postero Anterior (PA) Projection: 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
*:* Lateral Projection: The adult heart is 6 cm in the antero posterior (AP) direction


====X-ray findings for left ventricular enlargement====
====X-ray findings for left ventricular enlargement====

Revision as of 16:18, 3 January 2013

Cardiomegaly Microchapters

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Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Cardiomegaly from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

MRI

CT

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

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Case #1

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Risk calculators and risk factors for Cardiomegaly chest x ray

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Chest X Ray

  • Cardiomgaly 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: 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
Cardiomegaly.
Image courtesy of C. Michael Gibson MS. MD


Cardiomegaly in a patients after mitral valve replacement. AP view. Image courtesy of RadsWiki


Cardiomegaly in a patients after mitral valve replacement. Lateral view. Image courtesy of RadsWiki.


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
Double density sign


Double density sign


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.

References

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