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Basics of CT Scan Head and Trauma Radiographs
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Ujjwal Gorsi, Chirag Kamal Ahuja
Airway injuries are uncommon. Bronchial tears involve the right side, commonly within 2.5 cm of the carina. Radiographic findings include pneumothorax, pneumomediastinum and subcutaneous emphysema. Radiographic findings which suggest oesophageal injury are left pleural effusion, left lower lobe atelectasis, pneumomediastinum and left pneumothorax. Trauma to heart and pericardium may cause pericardial effusion or pneumopericardium. Radiographic features of effusion include global enlargement of the cardiac silhouette.
Heart Failure in Adult Congenital Heart Disease
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Andrew Constantine, Ana Barradas-Pires, Isma Rafiq, Justyna Rybicka, Michael A. Gatzoulis, Konstantinos Dimopoulos
The plain chest radiograph provides information about the heart and surrounding structures, including visceral and atrial situs, the position of the heart, signs of prior thoracic surgery, and the position of radio-opaque devices. Knowledge of the cardiac silhouette allows quick assessment of chamber enlargement, aortic anatomy, and venous drainage. The pattern of pulmonary vascular markings can alert the physician to the presence of pulmonary venous or arterial hypertension, as well as to pulmonary plethora or oligemia. In the acute setting, assessing signs of congestive HF, pulmonary edema, consolidation, and assessment of line and tube positioning are an essential part of daily practice.
The cardiovascular system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Chest X-ray A good quality postero-anterior (PA) X-ray of the chest will provide considerable information about both the heart and the lung fields. The cardiac silhouette in the PA view usually appears as shown in Fig. 2.25.
Hydralazine-induced pericardial effusion
Published in Baylor University Medical Center Proceedings, 2019
Mohammed Faisal Rahman, Muhammad Ajmal Panezai, Harold M. Szerlip
His blood pressure was 114/62 mm Hg; pulse, 79 beats/min; respiratory rate, 20 breaths/min; temperature, 97.5°F; and oxygen saturation, 100% in ambient air. The lungs were clear to auscultation. His jugular venous pressure was estimated to be 8 to 10 cm H2O. His heart sounds were audible, with prominent S4 and no murmur. The liver was extended 4 to 5 cm below the right costal margin. There was 1+/4+ lower-extremity edema. The hemoglobin was 7 mg/dL (from a baseline of 9 mg/dL); blood urea nitrogen, 61 mg/dL; creatinine, 8.6 mg/dL; total bilirubin, 1.7 mg/dL; alkaline phosphatase, 278 mg/dL; albumin, 2.9 g/dL; total protein, 7.2 g/dL; serum iron, 59 μg/dL; percent saturation, 44%; ferritin, 2300 ng/mL; and thyroid-stimulating hormone, 1.24 IU/mL. White cell and platelet counts, serum electrolytes, and transaminases were normal, and troponin, serum markers for hepatitis B and hepatitis C infection, and interferon gamma release assay were negative. The erythrocyte sedimentation rate was significantly elevated at 140 mm/h. Antihistone antibody was positive, but ANA was negative. Other autoantibodies were not checked due to negative ANA. Chest x-ray showed an enlarged cardiac silhouette (Figure 1a). Transthoracic echocardiography revealed an ejection fraction of 65% and a large circumferential pericardial effusion without evidence of tamponade (Figure 1b).
Postpericardiotomy syndrome after cardiac surgery
Published in Annals of Medicine, 2020
Joonas Lehto, Tuomas Kiviniemi
The pericardial effusion can often be detected on chest x-ray as an enlargement of the cardiac silhouette. However, it is often difficult to tell whether this enlargement is cardiac or pericardial or both [10,46,55]. According to recent studies, pericardial effusion can be detected as often as in 88–93% of the episodes [5,12,47]. The effusion is typically mild (<10 mm), and moderate (10–20 mm) and large (>20 mm) effusions are detected in 13% and 4% of the patients with detectable pericardial effusion, respectively [5]. Most patients (>80%) have combined pleuropericardial involvement [5,12]. The typical echocardiographic finding is presented in Figure 2.
A rare case of cytomegalovirus causing respiratory failure and a large pericardial effusion
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Leah Burkovsky, Wahab M. Kahloan, Aashish Acharya, Gayatri Nair, Ricardo A. S. Conti
On day 1, a chest radiograph (Figure 1(a)) revealed extensive right lung opacities, most prominent in the right middle lobe. The cardiac silhouette was slightly enlarged. A chest CT scan with intravenous contrast (Figure 2) revealed severe cavitary and partially necrotic opacities in the right upper lobe. There was also a small right pleural effusion and a moderate pericardial effusion. An echocardiogram (Figure 3) revealed a large pericardial effusion, as large as 4.16 cm, with no signs of tamponade.