What are the most common causes for an enlarged cardiac contour?
Cardiomegaly from ischaemic heart disease or cardiomyopathy, pericardial effusion, extracardiac mass abutting the heart.
What uncommon scenario is the cause of enlarged cardiac contour in this patient (HINT: there was a sudden change in cardiac contour following successful surgery).
Heterotopic heart transplant.
A monologue from which classical 19th century play makes an apt metaphor for having two beating hearts in one's chest?
Goethe's Faust: Two souls alas! are dwelling in my breast; And each is fain to leave its brother. The one, fast clinging, to the world adheres With clutching organs, in love's sturdy lust; The other strongly lifts itself from dust To yonder high, ancestral spheres. Courtesy of Dr Roberto Schubert
The patient's unusual cardiomediastinal contour is accounted for by a history of heterotopic heart transplantation. There is a native heart with a left ventricular aneurysm on the left, and the slightly smaller donor heart next to it on the right.