Cardiomegaly on chest X-ray (CXR) PA view in dilated cardiomyopathy. The cardiothoracic ratio is increased and there is a bulge along the left border, suggesting aneurysmal dilatation of the left ventricle. This pattern could be due to ischemic variety of dilated cardiomyopathy, sometimes called ischemic cardiomyopathy or ischemic dilated cardiomyopathy. The right border is also shifted to the right, indicating right atrial enlargement. Superior venacaval shadow is seen upwards from the right atrial contour, indicating congested superior vena cava. The shadow has also a superficial semblance to the egg on side appearance, though this is not a case of transposition of great arteries.