What is the abnormality on this chest X-ray?
Cardiomegaly. An abnormal left cardiac contour, with a focal bulging of the left ventricular outline.
What is the differential diagnosis?
The differential is broad and includes left ventricular aneurysm or masses abutting the heart / pericardium.
Mildly rotated to the left. Median sternotomy wires noted. There is cardiomegaly without evidence of pulmonary oedema. The left cardiac contour is abnormal, with a large focal prominence projecting laterally. The lungs and pleural recesses are clear.