The left ventricle makes up most of the left heart border.The right atrium makes up most of the right heart border. Inspect the borders of the heart which should be well defined in healthy individuals: Cardiomegaly can develop for a wide variety of reasons including valvular heart disease, cardiomyopathy, pulmonary hypertension and pericardial effusion. This rule only applies to PA chest X-rays (as AP films exaggerate heart size), so you should not draw any conclusions about heart size from an AP film.Ĭardiomegaly is said to be present if the heart occupies more than 50% of the thoracic width on a PA chest X-ray. a cardiothoracic ratio of less than 0.5). In a healthy individual, the heart should occupy no more than 50% of the thoracic width (e.g. Pleural thickening in the context of mesothelioma 2 The complete absence of lung markings should raise suspicion of a pneumothorax.Increased airspace shadowing in a given area of a lung field may indicate pathology (e.g.Some lung pathology causes symmetrical changes in the lung fields, which can make it more difficult to recognise, so it’s important to keep this in mind (e.g.Compare each zone between lungs, noting any asymmetry (some asymmetry is normal and caused by the presence of various anatomical structures e.g.Inspect the lung zones ensuring that lung markings are present throughout.the left lung has three zones but only two lobes). These zones do not equate to lung lobes (e.g.When interpreting a chest X-ray you should divide each of the lungs into three zones, each occupying one-third of the height of the lung.by an enlarging soft tissue mass) or pulled (e.g. You should inspect for evidence of the hilar being pushed (e.g.
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