Cardiomegaly
October 21st, 2019
Overview
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.
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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