Case 23 — Radiographs

Lateral

Lateral thoracic radiograph showing severe cardiomegaly with massive right atrial enlargement.
Lateral view.

DV

Dorsoventral thoracic radiograph showing massive right atrial enlargement occupying the right hemithorax from 6 to 12 o'clock, pushing the left heart to touch the left chest wall.
Dorsoventral view.

Quiz

1. These radiographs are not easy to read if you are seeing this abnormality for the first time. On the DV radiograph there is a dimple in the cardiac silhouette at 6 o’clock, just beneath the spine. What structure touches the right chest wall and lies between 6 o’clock and 12 o’clock?

Note that this structure is so large that it pushes the left heart over to touch the left chest wall.