Hoffman-Rigler sign (heart)

Last revised by Vincent Tatco on 10 May 2019

The Hoffman-Rigler sign is a sign of left ventricular enlargement inferred from the distance between the inferior vena cava (IVC) and left ventricle (LV).​

On a lateral chest radiograph, if the distance between the left ventricular border and the posterior border of IVC exceeds 1.8 cm, at a level 2 cm above the intersection of diaphragm and IVC, left ventricular enlargement is suggested 1.

Later investigators suggest this should be increased to 1.9 cm to decrease the number of false positives 2.

Prior to their publication in 1951, LV enlargement was suggested when the posterior LV border was more than 1.5 cm posterior to the IVC.

Hoffman-Rigler sign should not be confused with Rigler sign, Rigler triad or Rigler notch sign.

Richard ("Dick") B Hoffman (1937-2011) and Leo George Rigler (1896-1979 4), American radiologists, described their eponymous sign in a paper in 1965 3.

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Cases and figures

  • Figure 1
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