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Radiology of the Heart

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Level
General public
Study
medical...
School/University
UFMG

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documents in English
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.ppt
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presentations
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62 slides
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  1. Radiologic Anatomy
  2. Heart Size
  3. Chamber Enlargement
    1. Left atrium
    2. Left ventricle
    3. Right atrium
    4. Right ventricle
  4. Calcification
  5. Pulmonary Vasculature
  6. Pulmonary edema
  7. Pulmonary arterial hypertension
  8. Conclusions
  9. Bibliography

The heart casts a homogeneous shadow on the chest film. No internal detail can be seen within its contours because the radiodensities of blood, myocardium, and other cardiac tissues are so similar that one cannot be distinguished from the others. Only two borders of the heart, where it contacts the radiolucent, air-containing lung, can be discerned in any one projection.

[...] Air-containing lung interposed between this portion of the heart and the anterior chest wall forms the "retrosternal clear space." The posterior border of the heart extends from the level of the pulmonary carina to the diaphragm. Its upper half is formed by the back of the left atrium, and the lower half represents the posterior wall of the left ventricle. The shadow of the inferior vena cava is usually seen in the lateral projection extending obliquely upward and anteriorly from the diaphragm to enter the posterior aspect of the right atrium. [...]


[...] They can be separated by fluoroscopy as the aortic valve tends to move in a vertical direction as the heart beats, while the motion of the mitral valve approximates the horizontal. This distinction can also be accurately made from the lateral chest film. If a line is drawn from the left main bronchus, seen as a dark circular shadow over the lower extreme of the trachea, to the anterior costophrenic angle, then the mitral valve lies below the line and the aortic valve is above it. [...]


[...] Changes in the size and/or shape of the chambers of the heart and the great vessels usually alter the shape of the cardiac silhouette. However, because the heart is a three-dimensional structure, multiple views are required for complete radiographic evaluation. With the advent of echocardiography, the need for this "cardiac series" has disappeared. However, a remarkable amount of information regarding the heart is contained on standard frontal and lateral chest films, which remain a useful tool for detecting disease, evaluating the severity of known disease, documenting the progress of disease, and assessing the efficacy of treatment. [...]

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