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Differential diagnosis for a small cardiothoracic ratio

Last revised by Daniel J Bell ◉ on 31 Jul 2024

Citation, DOI, disclosures and article data

Citation:

Weerakkody Y, Bell D, Elfeky M, et al. Differential diagnosis for a small cardiothoracic ratio. Reference article, Radiopaedia.org (Accessed on 03 Dec 2024) https://doi.org/10.53347/rID-9884

DOI:

https://doi.org/10.53347/rID-9884

Permalink:

https://radiopaedia.org/articles/9884

rID:

9884

Article created:

29 May 2010, Yuranga Weerakkody ◉

Disclosures:

At the time the article was created Yuranga Weerakkody had no recorded disclosures.

View Yuranga Weerakkody's current disclosures

Last revised:

31 Jul 2024, Daniel J Bell ◉

Disclosures:

At the time the article was last revised Daniel J Bell had no financial relationships to ineligible companies to disclose.

View Daniel J Bell's current disclosures

Revisions:

12 times, by 5 contributors - see full revision history and disclosures

Systems:

Chest, Cardiac

Sections:

Gamuts

Tags:

cardiology, refs, cases

Synonyms:

Differential diagnosis for a small heart size
Small cardiothoracic ratio (CTR)
Microcardia
Small CTR
Small heart
Decreased cardiothoracic ratio (CTR)
Low cardiothoracic ratio (CTR)
Reduced cardiothoracic ratio (CTR)
Small cardiac silhouette
Small heart syndrome

A small cardiothoracic ratio (CTR) is defined as a cardiothoracic ratio <42%/0.42 when assessed on a PA chest radiograph, and is often called small heart syndrome. A pathologically-small heart is also known as microcardia.

It can be due to/associated with a number of entities:

adrenal insufficiency, e.g. Addison disease
heart transplant
cachectic state
- advanced age
- malnutrition
- bulimia nervosa
- anorexia nervosa
- advanced malignancy
asthmatic paroxysm with emphysema
constrictive pericarditis
myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) ³
physiological factors: e.g. Valsalva maneuver

References

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