Shmoo sign

Last revised by Daniel J Bell on 11 Dec 2020

Shmoo sign refers to the appearance of a prominent, rounded left ventricle and dilated aorta on a plain PA chest radiograph giving the appearance of Shmoo, a fictional cartoon character in the comic strip Li'l Abner, which first appeared in 1948 5. This sign is indicative of left ventricular enlargement.

History and etymology

According to Larry Elliott (1931-2016) 4, a cardiovascular radiologist from the University of Florida, it was one of his teachers, Lewis Carey, a radiologist from the University of Minnesota who first described this sign 2,3

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Cases and figures

  • Figure 1: annotated image
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