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SVC
IVC
RA
RV
PA
LA
LV
Aorta
Right border
Right border
Left border
Aortic knob
Main pulmonary trunk
Left ventricle
Pulmonary Arteries
Right
Pulmonary Arteries
Right
Left
LA
Pulmonary Arteries
Right
Left
Pulmonary Veins
Lateral View
SVC
RA
IVC
Lateral View
RV
Lateral View
Lateral View
LA
Lateral View
LV
Lateral View
Aorta
Lateral View
Lateral View
Left atrium
Left ventricle
Lateral View
Left atrium
Left ventricle
Right ventricle
Lateral View
Aorta
Lateral View
Pulmonary Arteries
Left
Right
Pulmonary Veins
Systemic Approach
Is it
adequate
or optimal for
cardiac evaluation?
Things to consider:
Position
Inspiration
Exposure
Things to consider:
Position
Things to consider:
Inspiration
Things to consider:
Exposure
Cardiac Positions:
Cardiac Positions:
Visceroatrial Situs:
Visceroatrial Situs:
Situs solitus:
Situs inversus:
Visceroatrial Situs:
Situs ambiguous:
Dextrocardia
Situs solitus
Dextrocardia
Situs inversus
Situs ambiguous
Cardiac Size
Cardio-Thoracic Ratio
Cardiac Size
Cardio-Thoracic Ratio
Chamber Enlargement
Cardiac enlargement
RightAtrial Enlargement
Chamber Enlargement
Right Ventricular
Enlargement
Chamber Enlargement
Right Ventricular
Enlargement
Chamber Enlargement
PA view:
Double density
Enlargement of LA
appendage
Upliftment of left mainstem
bronchus
Widening of carinal angle
Chamber Enlargement
Lateral view:
Prominent posterosuperior
cardiac border
Posterior displacement and
upliftment of left mainstem
bronchus
Chamber Enlargement
Left Ventricular
Enlargement
Chamber Enlargement
Left Ventricular
Enlargement
Lateral view:
posterior displacement of
the posterior inferior border
of the heart
Hoffman-Rigler Sign:
measured 2 cm above the
intersection of the
diaphragm & IVC; (+) if
posterior border extends
more than 1.8 cm of IVC
NORMAL
NORMAL
NORMAL
NORMAL
INCREASED
NORMAL
INCREASED
NORMAL
DECREASED
NORMAL
DECREASED
NORMAL
VENOUS
CONGESTION
INCREASED
ARTERIAL
BLOOD FLOW
VENOUS
CONGESTION
Kerleys B lines
VENOUS
CONGESTION
Perihilar Haziness
VENOUS
CONGESTION
VENOUS
CONGESTION
Redistribution:
equalization
VENOUS
CONGESTION
Redistribution:
cephalization
VENOUS
CONGESTION
Redistribution:
cephalization
Kerley B Lines
VENOUS
CONGESTION
Interstitial Edema
Kerley A Lines
VENOUS
CONGESTION
Kerley B Lines
Interstitial Edema
Alveolar Edema
VENOUS
CONGESTION
PCWP
VASCULAR PATTERN
<8 mmHg
Normal
10-12 mmHg
12-18 mmHg
Aorta
normal
prominent
diminutive
Main pulmonary
artery
normal
prominent
concave
Aorta
normal
prominent
diminutive
Main pulmonary
artery
normal
prominent
concave
Aorta
normal
prominent
diminutive
Main pulmonary
artery
normal
prominent
concave
Aorta
normal
prominent
diminutive
Main pulmonary
artery
normal
prominent
concave
Aorta
normal
prominent
diminutive
Main pulmonary
artery
normal
prominent
concave
Sample Cases
normal
normal
TOF-
TOF
Hypovascular lung
Concave MPA
Prominent aorta
RVH
PAPVR
ASD RV, PA enlargement. Increased PBF. Lateralanterior bowing of sternum indicative of hyperventilation L to
R shunt
PS VALVAR
Hypovascular
Dilated MPA
RVH
AI
Normal vascularity
Dilated aorta
LVH
Aortic aneurysm
PULMONARY EDEMA