Left ventricular enlargement

Left ventricular enlargement can be the result of a number of condition, including:

Radiographic features

Plain radiograph

Features that may be visible on a chest radiograph include:

  • in left ventricular dilatation, the left heart border is displaced leftward, inferiorly and posteriorly
  • left ventricular hypertrophy may show rounding of the cardiac apex
  • Hoffman-Rigler sign
  • Shmoo sign

The parasternal long axis and apical 4 chamber views on transthoracic echocardiography are often the primary views used to gain both a qualitative and quantitative appreciation of left ventricular enlargement. Features include 4:

  • increased left ventricular internal end-diastolic diameter (LVIDd)
    • parasternal long axis LVIDd > 5.3 cm (females) or > 5.9 cm (males)
  • elevated left ventricular volumes
    • diastolic volumes > 104 mL (females) or > 155 mL (males)
    • systolic volumes > 49 mL (females) or > 58 mL (males
  • increasingly spherical morphology
    • a normal left ventricle has prolate ellipsoidal morphology, with a long axis roughly twice that of the short axis
    • with severe LV enlargement the short axis dimensions may approximate those of the long axis, akin to a sphere
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Article information

rID: 12943
System: Cardiac
Tag: chest, cxr, cases
Synonyms or Alternate Spellings:
  • LV enlargement

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Cases and figures

  • Figure 1: normal PA cardiomediastinal outlines
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  • Figure 2: diagram (frontal)
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  • Figure 3: diagram (frontal)
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  • Figure 4: diagram (lateral)
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  • Figure 5: diagram (lateral)
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  • Figure 6: Shmoo sign
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  • Figure 7: Hoffman-Rigler sign
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