R2 Salomon, Marc | BMC Radiology

Hi Marc

The questions you have to address are:
- Frontal X ray
  - Is there cardiomegaly based on CT ratio or shape of the heart See Casey’s part on how to assess CXR frontal
  - Is there LA enlargement
  - Is there CHF
- Lateral X-ray
  - Is there RVE or LVE
    - See Cynthia’s page

? Cardiomegaly ? CHF

CARDIOMEGALY – LVE RVE
Chest Xray of a 65 year old female with longstanding history of SLE, Lupus Sjogren’s and Raynaud’s presented with 2 weeks of dyspnea and elevated troponins suggestive of a STEMI.

Places to review

Cardiothoracic ratio
Shape of the Heart (ovoid or triangle)
Carinal angle for LA enlargement
Equalisation cephalisation, interstitial edema

CARDIOMEGALY – LVE RVE
Chest X-ray of a 65-year-old female with longstanding history of SLE, Lupus Sjogren’s and Raynaud’s presented with 2 weeks of dyspnea and elevated troponins suggestive of a STEMI. CXR on the frontal view shows a CT ratio that is probably normal, equivocal carinal angle and no evidence of CHF. Lateral exam suggests RVE with RV : sternal ration being >30% and LV: diaphragm ratio being >33%
Ashley Davidoff MD

Answer

Probable LVE and RVE

Unusual PA not enlarged and LA not enlarged

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