Comparative study of cardiac size by chest X-ray and echocardiography

Introduction: The study of cardiac size is important for the diagnosis of various types of cardiac diseases such as left ventricular enlargement due to aortic stenosis and right ventricular enlargement due to pulmonary stenosis. Although echocardiography is considered as gold standard for the diagnosis of cardiomegaly, it is costly and needs trained personnel for performing and interpreting the results of this diagnostic procedure. Chest X-ray is used as an alternative. Materials and methods: The present comparative study was carried on 35 males aged 25–60 years. On the basis of provisional clinical diagnosis, the patients were divided into three groups: (i) group A - 15 patients in whom clinical history did not suspect any cardiac enlargement; (ii) group B - 15 patients whose clinical history predisposed to left ventricular enlargement; and (iii) group C - 5 patients whose clinical history predisposed to right ventricular enlargement. All patients underwent chest X-ray (postero-anterior view) and 2D-echocardiography examinations. The findings of the two modalities were compared. Observations: The observations were very informative and showed that chest X-ray is useful for the diagnosis of cardiomegaly due to various types of cardiac diseases. On chest X-ray, the cardiothoracic ratio and transverse diameter showed a strong positive correlation with total ventricular dimension on echocardiography. Other parameters such as transverse diameter and transverse left diameter on chest X-ray also showed a positive correlation with right ventricular dimension on echocardiography. Conclusion: Chest X-ray is a reliable alternative for the diagnosis of cardiomegaly in the absence of echocardiography.