Biatrial enlargement on Chest X-ray

X-ray chest PA view showing biatrial enlargement

Right atrial enlargement is manifest as a shift of the right atrial contour to the right side and left atrial enlargement is manifest as a double atrial contour within the right atrial shadow. Straightening of the left border and elevation of left bronchus are other features of left atrial enlargement on chest X-ray. Upper lobe vessels are prominent, suggesting a redistribution of pulmonary blood flow (also known as cephalisation and antler sign). Horizontal lines near the cardiophrenic angles due to thickened alveolar septa are known as Kerley B lines.

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