Cardiomegaly chest x ray: Difference between revisions
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*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. | *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. | *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==== | ||
*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==== | ||
Revision as of 16:19, 3 January 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]
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.
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.