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Test Findings




    • Look For

    • The cardiac shadow accounting for more than 50% of the chest width.
  • Note that the cardiac shadow will be artificially widened on an AP film, and this should only be assessed on a PA film.
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    • Causes of Cardiomegaly

    • Dilated Cardiomyopathy

    • Familial dilated cardiomyopathy
    • Ischaemic heart disease
    • Infection - viral myocarditis, HIV, trypanosomiasis
    • Toxins - alcohol, cocaine, anthracyclines, trastuzumab
    • Connective tissue disease - scleroderma, systemic lupus erythematosus
    • Tachycardia-mediated cardiomyopathy
    • Peripartum cardiomyopathy
    • Left Ventricular Hypertrophy

    • Physiologic - athletes, pregnancy
    • Hypertensive heart disease
    • Valvular disease - aortic stenosis, aortic regurgitation, mitral regurgitation
    • Hypertrophic (obstructive) cardiomyopathy
    • Aortic coarctation
    • Right Ventricular Hypertrophy

    • Cor pulmonale - pulmonary arterial hypertension, chronic lung disease, chronic pulmonary embolism
    • Valvular disease - tricuspid regurgitation, mitral stenosis
    • Congenital heart disease - atrial septal defect, ventricular septal defect, tetralogy of Fallot
    • Constrictive pericarditis
    • Other

    • Large pericardial effusion
    • Infiltrative disease - haemochromatosis, amyloidosis, sarcoidosis
    • Hyperdynamic state - anaemia, hyperthyroidism, obesity, AV fistula
    • Arrhythmogenic right ventricular cardiomyopathy
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