Chest PA Chest Lat

Chest PA

Trachea

Patient’s PA CXRNormal PA CXR

(-) blunting of the costophrenic angle(-) pulmonary congestion

(-) pulmonary infiltrates (-) bone deformities

(-) flattening of the R&L hemidiaphragm(-) tracheal deviation

Patient’s PA CXRNormal PA CXR

(+) heart enlargement

Slight straightening of the L cardiac border

Normal location of the apex: 5th ICS, MCL

Normal PA CXR

The patient’s apex is located on the 7th ICS MCL

– DOWNWARD DISPLACEMENT OF THE APEX

Patient’s PA CXR

Patient’s PA CXRNormal PA CXR

Cardio-thoracic Ratio

Which chamber/s is/are enlarged?

Squire’s Fundamentals of Radiology, 6th ed.

1 – R brachiocephalic vessels

2 – Ascending aorta and superimposed SVC

3 – R atrium

5 – L brachiocephalic vessels

6 – Aortic arch

7 – Pulmonary trunk

8 – L atrial appendage

9 – L ventricle

Normal LVE LAE LAE & LVE (in long-standing MS)

Patient’s PA CXRNormal PA CXR

Prominent L atrial appendage

Left Atrial Enlargement

Patient’s PA CXRNormal PA CXR

Carina not appreciated (cannot be measured for widening)

Patient’s PA CXRNormal PA CXR

No double density along the R cardiac border

Normal PA CXR

Downward dipping of

the left heart

Patient’s PA CXR

Possible L Ventricular Enlargement

Normal PA CXR

LV outflow tract

Patient’s PA CXR

Possible L Ventricular Enlargement

Possible R Ventricular EnlargementNormal PA CXR

Rounding of the cardiac apex

Patient’s PA CXR

Lateral Chest Xray

Normal Lateral CXR Patient’s Lateral CXR

Trachea

EsophagusTrachea

Esophagus

Heart

Heart

Left atrial enlargement

Esophagus

Retrocardiac free space

Esophagus

Retrocardiac free space

LV outflow tract

Left cardiac border

Left cardiac border

LV outflow tract

Left venticular enlargement

Convex posterior heart border

Posterior margin of the IVC Obliterated posterior margin of the IVC

Left venticular enlargement

Left venticular enlargement

Hoffman Rigler sign

Right ventricular enlargement

Retrosternal space

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Retrosternal space