Moguls of the heart
Citation, DOI, disclosures and article data
Citation:
Tatco V, Knipe H, Kang O, Moguls of the heart. Reference article, Radiopaedia.org (Accessed on 05 Dec 2024) https://doi.org/10.53347/rID-43465
rID:
43465
Article created:
11 Mar 2016,
Vincent Tatco
Disclosures:
At the time the article was created Vincent Tatco had no recorded disclosures.
View Vincent Tatco's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Henry Knipe had no recorded disclosures.
View Henry Knipe's current disclosures
Revisions:
3 times, by
3 contributors -
see full revision history and disclosures
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Tags:
Synonyms:
- Cardiac moguls
- Cardiomediastinal moguls
The 'moguls of the heart' refer to the bulges of the cardiomediastinal contour on frontal chest radiographs. The cardiomediastinal bulges are likened to skiing moguls (bumps of packed snow on a mountainside sculptured by turning skis). Awareness of their usual locations and etiologies is helpful in their recognition.
Radiographic features
On the right cardiomediastinal border:
- the right atrium is the only normal bulge
On the left cardiomediastinal border:
-
first mogul
- uppermost, located paratracheally above the carina, and formed by the aortic arch (aortic knob)
- prominence may be due to ectasia, aneurysm, or hypertension
- notching or a "figure 3" sign suggests coarctation of the aorta
-
second mogul
- located just above the left main bronchus and represents the main pulmonary artery segment
- excessive convexity is seen in poststenotic dilatation, pulmonary arterial hypertension, significant left-to-right shunts and pericardial defects
- concavity suggests right-to-left shunts, pulmonary atresia, or malposed great vessels
-
third mogul
- never normal
- if present, it lies below the left main bronchus and is usually formed by a prominent left atrial appendage, which is commonly seen in rheumatic heart disease
- other causes include cardiac aneurysm, pericardial cyst, coronary artery aneurysm, mediastinal tumor, pericardial defect, sinus of Valsalva aneurysm, and dilated right ventricular outflow tract
-
fourth mogul
- bulge just above the diaphragm formed by the left ventricular margin or cardiac apex
-
fifth mogul
- bulge at the cardiophrenic angle
- may be caused by prominent pericardial fat pad, pericardial cyst, or adenopathy
History and etymology
The term was popularized by M Daves in the 1970s 1-3.
References
- 1. Wright FW. Radiology of the Chest and Related Conditions. CRC Press. (2001) ISBN:0415281415. Read it at Google Books - Find it at Amazon
- 2. Reeder MM. Reeder and Felson’s Gamuts in Radiology. Springer Science & Business Media. (2013) ISBN:1475722699. Read it at Google Books - Find it at Amazon
- 3. A chest radiograph showing abnormal mediastinal contour. Chest. 1996;109 (5): 1383-4. Pubmed citation
- 4. Mettler FA Jr. Essentials of Radiology. Elsevier Health Sciences. (2013) ISBN:1455750689. Read it at Google Books - Find it at Amazon
- 5. FAAC LRGMD. Felson's Principles of Chest Roentgenology. Saunders. (2007) ISBN:1416029230. Read it at Google Books - Find it at Amazon
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