Chest X Ray : Heart Failure Dr.Juan A.Venter Dept.Imaging
Sciences Universitas Hospital
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Causes:PVH/Pulmonary Oedema Left Ventricular Failiure Left
Ventricular Outflow Obstruction Mitral Valve Disease Left Atrial
Myxoma Fibrosing Mediastinitis Pulmonary Venous Occlusive
Disease
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Non Cardiogenic Pulmonary Oedema Normal Cardiothoracic Index
Aspiration,Near Drowning ARDS Hepatorenal Failiure Post
thoracocenthesis Rapid Lung Expansion Drugs :
Aspirin,Nutrofurantoin,Opiates,Cytokines PS:Early post MI phase
acute decrease in miocardial compliance
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Right Atrial Enlargement PA CXR: Prominent round superior
border with SVC > 5,5 cm from midline to most lateral RA margin
> 2,5 cm from right vertebral margin
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Right Ventricular enlargement PA CXR: Upturned cadiac apex
Lateral CXR: > 1/3 contact distance from cadiophrenic sulcus to
sternal angle
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Left Atrial Enlargement PA CXR: Retrocardiac double density
>75 % splaying of carina with horizontal orientation of left
mainstem bronchus Enlarged left convex left atrial appendage > 7
cm from LMB to right LA border. Lateral CXR: Posterior displacement
of Ba filled oesophagus
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Left Ventricle Enlargement PA CXR: Downturned cardiac apex with
leftward displacement Left diaphragmatic inversion Lateral CXR:
Posterior cardiac margin > 1,8 cm posterior to IVC meassured 2
cm above intersection of right hemidiaphragm with
IVC.(Hofman-Rigler rule)
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Cardiac vs Non Cardiac Oedema SignsCardiacRenal /Fluid Overload
ARDS CARDIOMEGALY(uremic pericarditis) VASCULAR
REDISTRIBUTIONBalanced WIDENED VASCULAR PEDICLE KERLEY LINES
PERIBRONCHIAL CUFFING AIRSPACE OPACIFICATIONBasalCentralDiffuse
PLEURAL EFFUSIONSVery Common Common