Gross Cardiomegaly on Chest X-ray PA View

Gross Cardiomegaly on Chest X-ray PA View

Have a look at this Chest X-ray PA view and try to make out the findings and their interpretation.

Gross cardiomegaly on Chest X-ray PA view, with gross right atrial enlargement evidenced by the shift of the right border very much into the right hemithorax. Main pulmonary artery and right pulmonary artery shadows are also prominent. Clinically and echocardiographically there was severe mitral and tricuspid regurgitation and pulmonary hypertension. Though similar enlargement of the cardiac silhouette could be noted in a large pericardial effusion, the bulges along the contour are not seen in massive pericardial effusion.  Elevated left bronchial shadow and a filling of the left atrial appendage region on the left border indicate associated left atrial enlargement.

RA: Right atrium; RPA: Right pulmonary artery; MPA: Main pulmonary artery; LAA: Left atrial appendage; Elevated LB: Elevated left bronchus.