Huge cardiomegaly

Case contributed by Dr Mohamed Mahmoud Elthokapy

Presentation

History of previous open-heart surgery and valve replacement and now complaining shortness of breath, poor exercise tolerance and pitting lower limb edema

Patient Data

Age: 50 years
Gender: Male

Markedly increased cardio-thoracic ration with flask-shaped heart.

Splaying of the carina indicating atrial enlargement.

Changes related to open-heart surgery with median sternotomy sutures and mitral valve repair with metallic prosthesis.

ECG leads are incidentally seen.

  • extensive cardiomegaly (cardiothoracic ratio about 95 %) with hugely dilated both atria
  • changes related to open-heart surgery (median sternotomy sutures) with mitral valve prosthesis  
  • markedly dilated IVC with systemic venous congestion, cardiac cirrhosis, and mild ascites
  • bilateral lower lung lobes sub-segmental consolidative atelectatic bands

Case Discussion

A known cardiac patient with past history of valvular replacement presented by flask-shaped heart on plain radiography, CT confirmed huge cardiomegaly rather than pericardial effusion.

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