Left ventricular enlargement
Citation, DOI, disclosures and article data
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosuresAt the time the article was last revised Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosures- LV enlargement
- LV dilatation
Left ventricular enlargement can be the result of a number of conditions, including:
- pressure overload
- volume overload
- wall abnormalities
Radiographic features
Plain radiograph
Features that may be visible on a chest radiograph include:
- left ventricular dilatation: left heart border is displaced leftward, inferiorly and posteriorly
- left ventricular hypertrophy: may show rounding of the cardiac apex
- Hoffman-Rigler sign
- Shmoo sign
Echocardiography
The parasternal long axis and apical four-chamber views on transthoracic echocardiography are often the primary views used to gain both a qualitative and quantitative appreciation of left ventricular enlargement.
Features include 4:
- increased left ventricular internal end-diastolic diameter (LVIDd)
- parasternal long axis LVIDd >5.3 cm (females) or >5.9 cm (males)
- elevated left ventricular volumes
- diastolic volumes >104 mL (females) or >155 mL (males)
- systolic volumes >49 mL (females) or >58 mL (males)
- increasingly spherical morphology
- a normal left ventricle has prolate ellipsoidal morphology, with a long axis roughly twice that of the short axis
- with severe LV enlargement the short axis dimensions may approximate those of the long axis, akin to a sphere
CT
One publication has suggested left ventricular enlargement being able to be reliably identified on non-gated contrast-enhanced multidetector CT (with sensitivity of 78% and specificity of 100%) when the maximum luminal diameter of the LV is greater than 5.6 cm 5.
References
- 1. Miller SW. Cardiac imaging, the requisites. Mosby Inc. (2005) ISBN:032301755X. Read it at Google Books - Find it at Amazon
- 2. Brant WE, Helms C. Fundamentals of Diagnostic Radiology. LWW. ISBN:1608319113. Read it at Google Books - Find it at Amazon
- 3. Webb WR, Higgins CB. Thoracic Imaging. Lippincott Williams & Wilkins. (2010) ISBN:1605479764. Read it at Google Books - Find it at Amazon
- 4. Kou S, Caballero L, Dulgheru R, Voilliot D, De Sousa C, Kacharava G, Athanassopoulos GD, Barone D, Baroni M, Cardim N, Gomez De Diego JJ, Hagendorff A, Henri C, Hristova K, Lopez T, Magne J, De La Morena G, Popescu BA, Penicka M, Ozyigit T, Rodrigo Carbonero JD, Salustri A, Van De Veire N, Von Bardeleben RS, Vinereanu D, Voigt JU, Zamorano JL, Donal E, Lang RM, Badano LP, Lancellotti P. Echocardiographic reference ranges for normal cardiac chamber size: results from the NORRE study. (2014) European heart journal cardiovascular Imaging. 15 (6): 680-90. doi:10.1093/ehjci/jet284 - Pubmed
- 5. Kathiria N, Devcic Z, Chen J et al. Assessment of Left Ventricular Enlargement at Multidetector Computed Tomography. J Comput Assist Tomogr. 2015;39(5):794-6. doi:10.1097/RCT.0000000000000279 Copy Citation
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- Anomalous left coronary artery from the pulmonary artery
- Hoffman-Rigler sign (heart)
- Cardiac chamber enlargement
- Shmoo sign
- Mitral annular dilation
- Mitral valve regurgitation
- Animal and animal produce inspired signs
- Cardiomegaly
- Cardiac silhouette
- Barth syndrome
- Left ventricle
- Acute coronary syndrome
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