Cardiomegaly chest x ray
Chest X Ray
Cardiomegaly chest x ray On the Web
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.
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.
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