Hoffman-Rigler sign of left ventricular enlargement

Case contributed by Vincent Tatco
Diagnosis certain


Diagnosed case of aortic regurgitation by echocardiography.

The lower posterior heart border is displaced posteriorly reflective of left ventricular enlargement.

Annotated image demonstrating the borders of the left ventricle (LV) and inferior vena cava (IVC) on the lateral chest radiograph.

Annotated image demonstrating the Hoffman-Rigler sign. Left ventricular enlargement is suggested on lateral chest radiograph if the distance (D) between the LV border border and the posterior border of IVC is more than 1.8 cm at a level 2 cm above the intersection of diaphragm and IVC.

Case Discussion

This case demonstrates the Hoffman-Rigler sign of left ventricular enlargement on lateral chest radiograph.

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