Answers :
The chest radiograph shows the patient has an enlarged heart.
What chamber of the heart is enlarged ?
The left atrium is enlarged (and the left ventricle is enlarged).
What are the signs to look for to determine which chamber is enlarged ?
a) The left heart border has a bulge - this is enlargement of the left atrial appendage.
annotate left atrial appendage
b) There is a double right heart border.
annotate double right heart border
c) There is widening of the carina.
annotate the carina
What valve has been replaced ?
This is a mitral valve replacement. An aortic valce replacement would be higher and point the other way.
annotate mitral valve
What complications are present ?
There is a pleural effusion and the patient is in heart failure. The upper lobe veins are dilated suggesting pulmonary venous hypertension. In addition, the pulmonary arteries are big suggesting pulmonary artery hypertension.
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