Cardiomegaly

Last revised by Dylan Suyama on 24 Sep 2019

Cardiomegaly is a catch-all term to refer to enlargement of the heart, and should not be confused with causes of enlargement of the cardiomediastinal outline, or enlargement of the cardiac silhouette

There are many etiologies for cardiomegaly:

In most cases, merely 'eye-balling' a chest x-ray will be sufficient in detecting cardiomegaly (as the heart is either clearly normal in size or clearly abnormally enlarged). In equivocal cases, the cardiothoracic ratio (CTR) can be easily calculated on a PA chest x-ray. The CTR measures the width of the cardiac silhouette and the thoracic cavity; a ratio greater than 0.5 is an abnormal finding.

Specific cardiac chamber enlargement can be recognized by cardiac contour changes, new or different interfaces with adjacent lung, and/or displacement of adjacent mediastinal structures. These are discussed separately:

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 2
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  •  Case 3
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  • Case 4: with concurrent pleural effusion
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  • Case 5: right sided cardiomegaly
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