Chest X-ray Level 2 Tutorial: Congestive Heart Failure
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Tutorial: Congestive Heart Failure
Learn an approach to CHF findings on chest x-ray
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Tutorial: Congestive Heart Failure Enlarged Heart
Lessons
42
Times Practiced
1284
Cases Completed
1h 24m
Total Time spent
1m 24s
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1 Pathophysiology Pathophysiology
Current lesson 2 Enlarged Heart Enlarged Heart
3 Vessel to Bronchus ratio Vessel to Bronchus ratio
4 Vascular Redistribution Vascular Redistribution
5 Peribronchial Cuffing Peribronchial Cuffing
6 Kerley lines Kerley lines
7 Alveolar Edema Alveolar Edema
8 Fluid in fissures Fluid in fissures
9 Fluid in Pleural Space Fluid in Pleural Space
10 CHF Summary CHF Summary
Enlarged Heart
As the left ventricle dilates, the shadow of the heart becomes wider on the chest x-ray.

The width of the heart compared to the width of the thorax is called the cardiothoracic ratio.

A normal cardiothoracic ratio is < 0.5. In other words, the heart should be less than 50% of the width of the thorax.

Here is an example of a normal (< 0.5) cardiothoracic ratio. The yellow line represents the width of the heart. The blue line represents the width of the thoracic cavity:


Here is an example of an abnormal (wide) cardiothoracic ratio. The width of the heart is greater than 50% of the width of the thorax:


There are addition abnormalities in this chest x-ray that we will discuss in later modules.