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In a chest radiograph, you noted that the patient’s right cardiac border is prominent.  This is due to enlargement of what chamber?

Question

In a chest radiograph, you noted that the patient’s right cardiac border is prominent.

This is due to enlargement of what chamber?

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Solution

The prominence of the right cardiac border in a chest radiograph is typically due to the enlargement of the right atrium. Here are the steps to reach this conclusion:

  1. Understand the anatomy: The heart is divided into four chambers - the left atrium, the right atrium, the left ventricle, and the right ventricle. In a chest radiograph, the right cardiac border is formed by the right atrium and right ventricle.

  2. Analyze the radiograph: In a chest radiograph, if the right cardiac border is prominent, it suggests that one of the chambers forming this border is enlarged.

  3. Identify the chamber: The right atrium is the chamber that most commonly causes prominence of the right cardiac border when it is enlarged. This is because it is the most anterior part of the heart and thus forms the majority of the right heart border on a chest radiograph.

  4. Confirm the finding: Other signs of right atrial enlargement on a chest radiograph may include an increase in the size of the right atrial shadow and displacement of the barium-filled esophagus to the left (in a barium swallow study).

So, the enlargement of the right atrium is the most likely cause of a prominent right cardiac border on a chest radiograph.

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