Professional Documents
Culture Documents
Josef Siregar
One of the easiest
Cardio-thoracic observations to make is the
Ratio cardio-thoracic ratio which
is the widest diameter of the
heart compared to the
widest internal diameter of
the rib cage
<50%
In most normal people the
cardio-thoracic ratio is less
than 50%
Sometimes, the
cardiothoracic ratio is >50%
but the heart is still normal
AP PA
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.
How can you tell if the heart is enlarged
on an AP (usually portable) film
If the heart touches the lateral chest wall,
its 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