Dr. Pepe’s Diploma Casebook: Case 45 – SOLVED!

Diploma_casebook_case45

Dear Friends,

Today I am presenting the case of a 73-year-old woman who had preoperative radiographs for haemorrhoid treatment.

Check the two images below and leave me your comments and diagnosis in the comments. Come back on Friday for the answer!

Diagnosis:
1. Cyanotic heart disease
2. Acyanotic heart disease
3. No heart disease
4. None of the above


73-year-old woman, PA chest

73-year-old woman, PA chest

73-year-old woman, lateral chest

73-year-old woman, lateralchest

Click here for the answer

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19 Responses to : Dr. Pepe’s Diploma Casebook: Case 45 – SOLVED!

  1. yp says:

    Agenesis or hypoplasia of the right pulmonary artery

    • RAFAT says:

      ELEVATED R MEDIAL DIAPHRAGM WITH LARGE BAWOL INSIDE complecated with mass effect on heart LOCATED ANTERIOR IN THE LATERAL x ray i suppose morgagni heneria

      • Rafat Shahin says:

        ELEVATED L MEDIAL DIAPHRAGM WITH LARGE BAWOL INSIDE complecated with mass effect on heart LOCATED ANTERIOR IN THE LATERAL x ray i suppose morgagni heneria

    • Dr. Pepe says:

      If you cover the cardiac shadow and the equivalent area on the left, vascularization of both lungs is similar. And the right pulmonary artery on the lateral view has a normal size.

  2. genchi bari italia. says:

    destro-posizione cardiaca; area sclerotica ,disomogenea, sul peduncolo vertebrale di D10.

  3. Maria S. says:

    Dextrocardia. Most of the cardiac silouette is located in the right hemithorax. Note the increased radiopacity of the right hemithorax (hyperventilation). Decreased caliber and number of pulmonary vessels of the right lung. Right lung hypoplasia.
    Hypoplasia of right pulmonary artery? Is the pulmonary artery truk nirmal? The right pulmonary artery normal?

  4. Maria S. says:

    Dextrocardia. Most of the cardiac silouette is located in the right hemithorax. Note the increased radiopacity of the right hemithorax (hyperventilation). Decreased caliber and number of pulmonary vessels of the right lung. Right lung hypoplasia.
    Hypoplasia of right pulmonary artery? Is the pulmonary artery truk normal? The right pulmonary artery normal?

  5. gus says:

    It looks like prominence of the right cardiac border, ( right atrial enlargement ) but i think is not
    -The pulmonary artery is normal
    -all mediastinum is shifting to the right exept descending aorta.
    -these elevation of right frontal hemidiaphragm could be the key.
    i am working on it…

  6. gus says:

    sub diaphragmatic mass?

  7. sameh khodair says:

    I think it is a focal pericardial defect

    • Dr. Pepe says:

      Focal pericardial defects have a normal position of the heart with prominent left atrial appendage. Try again 😉

      • sameh says:

        I see that the shape of the cardiac shadow in the lateral view is abnormal as the posterior border became strait and the cardiac shadow looks like a (( Bell ))

      • sameh khodair says:

        so, I think about that the aorto-pulmonary window is obliterated

  8. genchi bari italia says:

    …carissimo collega, io avevo parlato appunto di dx-posizione e non di dx-cardia, intendendo così la normale posizione delle camere cardiache e dell’arco aortico:cuore “spostato” a dx.

    • Dr. Pepe says:

      I know you did and you deserve the credit. You were so early that I didn’t want to spoil the diagnosis for all the others.
      Again, congratulations!

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