Thursday, April 26, 2012

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Interpretation - Heart borders on Chest X ray

It is at times difficult to interpret a PA chest X-ray as the amount of information present is huge. A systematic approach should always be done. 

One should have the understanding of what is normal. This must include an evaluation of the 
1) soft tissues, 
2) bones and joints, 
3) pleura, lungs, major airways and pulmonary vascularity, 
4) mediastinum and its contents, 
5) heart and its chambers, as well as 
6) the areas seen below the diaphragm and above the thorax.

The heart borders are explained in this post. 
On the right side of the heart the following structures can be identified:
1) Az - Azygous vein
2) A - Ascending aorta
3) S - Superior vena cava
4) RA - Right atrium

On the left side of the heart, we can identify the following:
1) SC - Subclavian artery
2) AA - Aortic arch
3) PA - Pulmonary artery
4) LB - Lower border of pulmonary artery
5) LA - Left atrial appendage
6) LV - Left ventricle

The x-ray on the right side i.e. B shows the actual positioning of the heart in a normal individual. 


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