Chest X-ray: heart anatomy

Let’s fire through this so we can get into the fun stuff, pathology! Doctors are a quirky bunch and have a challenging career where interesting cases generally means bad news for the patient. However, collaborating with patients’ and healthcare providers as a team to treat, improve, and often overcome the scary situation is an amazing process! So check my prior post for a very cursory view of cardiac anatomy if you need it.

The frontal chest radiograph displays the left ventricle on the patient’s left and right atrium on the patient’s right. For all the non RT and radiologist readers, images performed by professional Radiation Technologists (RTs) document right or left with a marker containing the RTs initials on the image.

chest x-ray - frontal heart borders
RA = right atrium, LV = left ventricle            Technologist marker is flipped but labeling the correct side as left.

The lateral chest radiograph displays the left atrium (towards the head) and left ventricle (towards the feet) posteriorly/along the border towards the patient’s back. The right ventricle is the anterior border/towards the patient’s front.

chest x-ray - lateral heart borders
RV = right ventricle, LA = left atrium, LV = left ventricle

Lastly I will mention the pericardium, but in most healthy patient’s it is pretty much invisible on the chest X-ray. You see, as with most organs in our body, there is a capsule around the organ/heart. There is a thin layer of fluid often between 2 to 4 mm thick providing lubrication for our beating hearts. Imagine the friction burn if it were rubbing against all the other things in our chest cavity/thorax.

Had a fun 8 mile trail run with a good friend who is a local ENT/Head and Neck surgeon here in Reno, NV today. Head and Neck Radiology is my personal favorite and we haven’t touched it yet. I might call an audible and shift gears.

Hey, I’m going to be posting a video this coming week to my about me page taking you inside my home to a radiologist’s cave to get an inside look at how teleradiology and on-call services can be provided. Please check it out and sound off on what you want for future blogs/vlogs. I will be doing some flouroscopy to honor a request from a local RT. If you have a topic of interest, make a request in the comments below!

Thanks,

Ron

Posted by

I am an American Board of Radiology certified Diagnostic Radiologist with a certificate of additional qualification in Neuroradiology. I absolutely love my job. I have learned a tremendous amount about the human body, including its’ expected complications given our extraordinary complexity, and get to use that knowledge to help people. I personally have experienced emotional devastation and loss, which has made me compassionate and empathetic. I really care about people, and I hope I can use this site to help you. I graduated medical school in 2004 from New York Medical College. My wife and I had our first son in NY where we bought our 900 sf two bedroom one bath starter home. I stayed at Westchester Medical Center for radiology residency, where we had our second son. I obtained a neuroradiology fellowship position at Yale New Haven Medical Center commuting about an hour and a half each way for a year while we had our third boy. Upon graduation I was fortunate to return to Westchester Medical Center to work in Neuroradiology, Body Imaging, and Women’s Imaging departments, a rarity in academic medicine. Almost a decade later and I am living in a larger home in Reno working in a private practice community based outpatient radiology group which contracts with a rural hospital in Elko, Nevada. My wife and I now have four boys and gave up on the girl. We also have a male Bernese mountain Dog named Helmut and female Newfoundland named Lucy. Despite all its hardships and tremendous struggles, I have an absolutely amazing life, which is a gift I cherish. It’s down to my philosophy. I am a firm believer in teamwork. So much comes down to communication. When healthcare providers talk to each other one-on-one, the patient care is always improved, every time! We might not find an answer to your problem, but our collective knowledge sure can help improve your chances. At Yale the best conference I ever regularly attended was a head and neck tumor board. The head and neck surgeon (otolaryngologist = ENT) presented the patient’s clinical history, the radiologist showed the images, the oncologist discussed the tumor and chemotherapy options, and the patient came to the conference and we all did a physical exam looking into their mouth to directly visualize a tumor. It was incredible! Patients came from far and wide to see this highly trained, world-renowned, humble, Japanese, gentleman surgeon. It was also an epiphany. I found that when I see the patient, talk to them, listen to their story, examine them and discuss the patient with my colleagues, the patient felt better and I had a lot of fun. It’s weird but reminds me of seeing a comedy where it is always funnier in a packed theater with everyone laughing. Knowledge and compassion are both infectious and contagious. My greatest days are helping patients deal with some of their most difficult days, and I am good at it.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s