Melissa Enriquez Sims MD, MPH, Presenter: Nothing to Disclose

Shelley Shapiro MD, Abstract Co-Author: Nothing to Disclose

Bruce Millard Barack MD, Abstract Co-Author: Nothing to Disclose

Julius Harry Grollman MD, Abstract Co-Author: Nothing to Disclose

1. Review the structures contributing to the left heart border on the PA chest radiograph. 2. Demonstrate the structures responsible for the straightened left heart border in RV enlargement. 3. Contrast images from normal subjects with those from patients with pulmonary arterial hypertension, tricuspid insufficiency, Ebstein's anomaly and ASD.

1. Normal cardiac anatomy on PA chest radiographs. 2. Imaging findings of straightened left heart borders and right ventricular enlargement on PA chest radiographs and CT reconstructions (coronal, sagittal and 3D) from patients with pulmonary arterial hypertension, tricuspid insufficiency, Ebstein's anomaly, and atrial septal defect. 3. Imaging findings of normal left heart borders in patients with right ventricular enlargement and an increased retrosternal space (e.g. COPD).

The major teaching points of this exhibit are: 1. The structures responsible for the normal left heart border on a PA chest radiograph are the left atrium and left ventricle. 2. The structures responsible for the straightened left heart border on a PA chest radiograph are the enlarged and clockwise-rotated right ventricle and right ventricular outflow tract. 3. Demonstration of imaging findings for a spectrum of clinical disorders associated with right ventricle enlargement.

Sims, M, Shapiro, S, Barack, B, Grollman, J, Straightening of the Left Heart Border on PA Chest Radiographs: A Sign of Right Ventricular Enlargement.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8000825.html