Presentation
Chest pain.
Patient Data
Age: 16 years
Gender: Female
From the case:
Small cardiothoracic ratio
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Apparently small size of the heart, with a decreased cardiothoracic ratio (9/26=0.35).
From the case:
Small cardiothoracic ratio
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Normal cardiothoracic ratio (10.4/23=0.45).
Case Discussion
Commonly, abnormal cardiothoracic ratio refers to an increased ratio inferring cardiomegaly. In this case, there is a noticeably small ratio (0.35). A normal ratio is between 0.42 and 0.50.
The patient's haemoglobin level is 12 mg/dL excluding anaemia and no psychological or eating abnormalities. So, a repeat chest radiograph was recommended before further laboratory assessment or echocardiography, which surprisingly appeared normal (0.45). The abnormal ratio was suggested to be due to Valsalva manoeuvre during the first exam.
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