Cardiomegaly differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: pseudo-cardiomegaly; pseudocardiomegaly
Overview
Cardiomegaly must be distinguished from pseudo-cardiomegaly, a scenario in which the apparent size of the heart is artificially increased. Disorders and conditions which falsely increase the apparent size of the heart include straight back syndrome, a disorder in which the heart is "pancaked" or compressed; and obtaining the chest x-ray during expiration at which time the diameter of the lungs is decreased and the relative diameter of the heart and aorta is increased.
Diseases From Which Cardiomegaly Must Be Distinguished
- Epicardial fat pad
- Expiration: If the chest x-ray is obtained during expiration, the lung volume will be decreased and the cardiac size and aortic size will be relatively increased. The traditional metrics used to diagnose cardiomegaly do not apply in this case.
- Kyphoscoliosis
- Mediastinal mass
- Pectus excavatum
- Pulmonary blastoma[1]
- Straight back syndrome with pancake heart: This can cause a leftward shift of the heart on the chest x-ray. The heart can be "pancaked" or compressed.
- Thymus tumor
Differentiating Cardiomegaly from other Diseases
In alphabetical order. [2] [3]
- Acromegaly
- Alcoholic cardiomyopathy
- Amyloidosis
- Anemia
- Atrial myxoma
- Carcinoid
- Chronic obstructive pulmonary disease (COPD)
- Congenital heart disease
- Congestive Heart Failure
- Cor pulmonale
- Drugs
- Endocardial fibroelastosis
- Epicardial fat pad
- Fabry's disease
- Hemochromatosis
- Hurler's syndrome
- Hyperparathyroidism
- Hypertension
- Hypertrophic cardiomyopathy
- Hypocalcemia
- Hypomagnesemia
- Hypoparathyroidism
- Hypophosphatemia
- Idiopathic cardiomyopathy
- Ischemic heart disease
- Kyphoscoliosis
- Marfan's syndrome
- Mediastinal mass
- Myocarditis
- Normal athletic heart
- Pompe's disease
- Postradiation
- Pregnancy
- Primary pulmonary hypertension
- Pulmonary embolism
- Renal failure: Acute renal failure and chronic renal failure
- Scleroderma
- Sickle cell disease
- Subacute bacterial endocarditis
- Systemic lupus erythematosus
- Valvular heart disease
References
- ↑ http://casereports.bmj.com/content/2013/bcr-2013-010179.full.pdf
- ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
- ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X