Normal contours of the cardiomediastinum on chest radiography
Last revised by Bálint Botz
on 28 Jun 2021
Citation, DOI, disclosures and article data
Citation:
Gaillard F, Botz B, Dixon A, et al. Normal contours of the cardiomediastinum on chest radiography. Reference article, Radiopaedia.org (Accessed on 16 Feb 2025) https://doi.org/10.53347/rID-8469
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rID:
8469
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Disclosures:
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosures
Last revised:
28 Jun 2021,
Bálint Botz
Disclosures:
At the time the article was last revised Bálint Botz had no recorded disclosures.
View Bálint Botz's current disclosures
Revisions:
11 times, by
9 contributors -
see full revision history and disclosures
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Synonyms:
- Normal cardiomediastinal outline
A detailed understanding of the structures that make up the normal contours of the heart and mediastinum (cardiomediastinal contour) on chest radiography is essential if abnormalities are to be detected.
Frontal view (PA/AP)
Right cardiomediastinal contour
From superior to inferior:
-
right paratracheal stripe
- seen in two thirds of normal films 1
- made up of right brachiocephalic vein and SVC
- arch of the azygos vein
- ascending aorta in older individuals often projects to the right of the SVC
- superior vena cava (SVC)
- right atrium
- inferior vena cava (IVC)
Left cardiomediastinal contour
From superior to inferior:
-
left paratracheal stripe
- made up of left common carotid artery, left subclavian artery and the left jugular vein
- aortic arch +/- aortic nipple (left superior intercostal vein)
- pulmonary trunk
- auricle of left atrium
- left ventricle
Lateral view
Anterior cardiomediastinal contour
From superior to inferior:
-
superior mediastinum
- great vessels
- thymus
- ascending aorta
- right ventricular outflow tract
- right ventricle
Posterior cardiomediastinal contour
From superior to inferior:
- left atrium and pulmonary veins
- left ventricle
- inferior vena cava
Quiz questions
References
- 1. Collins J, Stern EJ. Chest radiology, the essentials. Lippincott Williams & Wilkins. (2007) ISBN:0781763142. Read it at Google Books - Find it at Amazon
- 2. Haller JO, Slovis TL, Joshi A. Pediatric radiology. Springer Verlag. (2005) ISBN:3540213546. Read it at Google Books - Find it at Amazon
Incoming Links
Articles:
- Right upper lobe collapse in the exam
- Cardiac chamber enlargement
- Chest radiograph
- Moguls of the heart
- Chest (supine view)
- Ascending aorta
- Chest curriculum
- Enlargement of the cardiac silhouette
- Right middle lobe collapse
- Right upper lobe collapse
- Left lower lobe collapse
- Left upper lobe collapse
- Assessment of cardiomediastinal contours on chest x-ray (approach)
- Chest (lateral view)
- Posterior mediastinal mass in the exam
- Azygos vein
- Traumatic aortic injury in the exam
- Left atrial enlargement
- Chest (AP erect view)
- Atrial escape
Cases:
- Pulmonary agenesis and dextrocardia
- Normal chest radiograph - pediatric
- Left ventricular enlargement on chest radiography (illustration)
- Left atrial enlargement on chest radiography (illustration)
- Right ventricular enlargement on chest radiography (illustration)
- Right atrial enlargement on chest radiography (illustration)
- Moguls of the heart (illustration)
- Left lower lobe collapse
- Retrosternal goitre
- Right middle lobe collapse
- Right lower lobe collapse
- Left upper lobe collapse
- Cardiomegaly
- Left upper lobe collapse
- Right middle lobe consolidation - patchy
- Right middle lobe consolidation - patchy
- Cardiomediastinal outlines on chest x-ray
- Pericardial effusion - water bottle sign
Multiple choice questions:
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