The heart and great vessels are apparent on a chest film because they are filled with blood that is relatively radiodense in comparison to the air-filled lungs which lie laterally. Standardly, posteroanterior (PA) films are taken so as to reduce artefactual magnification of the heart due to divergence of the x-rays.
On a PA film, the heart and great vessel borders are termed the cardiovascular silhouette. This should be inspected systematically for the presence and size of the expected structures - see submenu.
The sidedness of the aortic arch can be determined - even in a slightly rotated film - by looking which side of the trachea it lies. A right sided aortic arch would strongly suggest congential cyanotic heart disease.
The ventricles become rounded as they enlarge.
Examination of the lung vasculature of the lungs is important in analysis of the heart.
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