Professional Documents
Culture Documents
Dr. Josef Siregar
Dr. Josef Siregar
Josef Siregar
Cardio-thoracic
Ratio
<50%
Sometimes, the
cardiothoracic ratio is >50%
but the heart is still normal
These are the causes:
Portable AP films
Obesity
Pregnant
Ascites
Pectus excavatum
AP
PA
On an AP chest film (the usual portable chest radiograph in which the xray beam enters anteriorly and exits posteriorly), there is more
magnification. Look at the size of the heart in the two films on the same
patient side by side.
Inspiration
Expiration
>50%
The lower portion of this patients sternum bows inward toward the
heart. The heart is compressed between the sternal abnormality (which
is called a pectus excavatum deformity) and the spine. On the frontal
radiograph, the heart may appear enlarged.
Enlarged or not?
Yes
Yes
No
This is a pectus
excavatum deformity
of the sternum which
is compressing the
heart and making it
appear larger than it
really is. The clue to
the deformity on the
frontal film is the
extreme downward
orientation of the
anterior ribs.
No
Yes