Pulmonic regurgitation Chest X-Ray

Pulmonic regurgitation Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2], Aysha Anwar, M.B.B.S[3]

Overview

Chest x ray may not be required for the diagnosis of pulmonic regurgitation (PR). However, lateral and PA view of chest radiograph may help determining the right ventricular enlargement. Right atrial enlargement may also be seen in patients with concomitant tricuspid regurgitation.

Chest X ray

There are no chest x ray findings required for the diagnosis of pulmonic regurgitation. However, lateral and PA view of chest radiograph may help determine the complications and associated conditions of PR, which include right ventricular enlargement. Right atrial enlargement may also be seen in patients with concomitant tricuspid regurgitation.

• On CXR of a patient with PR secondary to pulmonary hypertension (PAH), featurs demonstrating PAH may include
• On CXR, right heart failure (RHF) which may be a complication of PR is chracterised by right ventricular enlargement. right ventricular enlargement od PA view demonstrates rounded left heart border and uplifted cardiac apex. On lateral view, filling of the retrosternal space and rotation of the heart posteriorly. CXR has limited utility in the diagnosis of RHF.
• On CXR of a patient with PR as a complication of tetrology of Fallot (TOF) repair, a “boot shaped” heart may be demonstrated.

Demonstration of Right Ventricular Enlargement

An illustration of right ventricular enlargement on PA view. The picture demonstrates the uplifting of cardiac apex - Case courtesy of Dr Vincent Tatco, Radiopaedia.org, rID: 46378

An illustration of right ventricular enlargement on lateral view - Case courtesy of Dr Vincent Tatco, Radiopaedia.org, rID: 46378

Chest X-ray Examples

Boot shaped heart demonstrated in Tetralogy of Fallot(TOF). The shoe tip is due to upturned cardiac apex owing to right ventricular hypertrophy and a concave pulmonary arterial segment gives rise to the top of boot- Case courtesy of Dr Vincent Tatco, Radiopaedia.org, rID: 43059