×
MedSchool: Ace Your OSCEsThe Medical Company
 
 
 
 
 
GET - On the App Store
View
Chest X-Ray
 
 

Overview

The cardiac silhouette is normally ovoid in apperance, with the apex pointing toward the left.

Right Atrial Enlargement

  • Look For

  • Bulging of the right side of the heart shadow.
  • Causes of Right Atrial Enlargement

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

Right Ventricular Enlargement

  • Look For

  • An up-turned apex
  • Loss of space between the cardiac shadow and the sternum on lateral chest x-ray
  • Causes of Right Ventricular Enlargement

  • 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
  • Dilation

  • Dilated cardiomyopathy - familial, ischaemic, alcoholic, viral myocarditis, drugs, connective tissue disease, tachycardia-mediated, peripartum
  • Other

  • Infiltrative disease - haemochromatosis, amyloidosis, sarcoidosis
  • Hyperdynamic state - anaemia, hyperthyroidism, obesity, AV fistula
  • Arrhythmogenic right ventricular cardiomyopathy
  • Constrictive pericarditis

Left Atrial Enlargement

  • Look For

  • Double density sign - a double cardiac border on the right side, due to the left atrium projecting behind the right atrium
  • Splaying of the carina with superior displacement of the left main bronchus
  • Slight bulging of the upper left cardiac border
  • Causes of Left Atrial Enlargement

  • Hypertensive heart disease
  • Valvular disease - mitral stenosis, aortic stenosis, mitral regurgitation
  • Hypertrophic (obstructive) cardiomyopathy
  • Aortic coarctation

Left Ventricular Enlargement

  • Look For

  • Displacement of the left cardiac border laterally, inferiorly and posteriorly
  • Rounded cardiac apex
  • Causes of Left Ventricular Enlargement

  • Hypertrophy

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

  • Dilated cardiomyopathy - familial, ischaemic, alcoholic, viral myocarditis, drugs, connective tissue disease, tachycardia-mediated, peripartum
  • Other

  • Infiltrative disease - haemochromatosis, amyloidosis, sarcoidosis
  • Hyperdynamic state - anaemia, hyperthyroidism, obesity, AV fistula

Boot-Shaped Heart

  • Look For

  • An up-turned apex (due to right ventricular hypertrophy) with a concave appearance of the main pulmonary artery.
  • Significance

  • A sign of tetralogy of Fallot.

Water Bottle-Shaped Heart

  • Look For

  • Diffuse enlargement of the cardiac shadow with a globular appearance.
  • Significance

  • Classically a sign of large pericardial effusion.
Next Page
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Want more info like this?
  • Your electronic clinical medicine handbook
  • Guides to help pass your exams
  • Tools every medical student needs
  • Quick diagrams to have the answers, fast
  • Quizzes to test your knowledge
Sign Up Now
   
 
 

Snapshot: Initialising...