Brief Answer:
Please consult a cardiologist for echocardiography

Detailed Answer:
Hi XXXXXX,
Thanks for writing in to us.

I have read through your query in detail.
In the findings of X ray mentioned by you, the heart size is slightly larger than normal (mild cardiomegaly) and the vessels at their site of entry into the lungs are appearing congested (due to altered hemodynamics of blood flow). There is also suspected small amount of fluid in the dependent parts of left chest cavity.

Since she has been treated for pulmonary embolism 4 years back and also has high blood pressure, a complete heart check up may be done by consulting a cardiologist. This may also involve doing an echocardiography. This will show if there is any problem in the flow of blood through the heart and it pumping action (ejection fraction) and whether her treatment medications need to be reviewed.

If she feels sudden onset of breathlessness then you may need to take her to hospital at the earliest. Cardiomegaly of mild degree requires monitoring of heart functions regularly and you can discuss in detail with the cardiologist after getting echocardiography done.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
?Minimal left pleural effusion

Detailed Answer:
Hi XXXXXX,
Thanks for writing back with an update.

Pain in the area need not necessarily be due to a condition of the heart. Cardiac pain usually manifests on exertion and radiates to left arm. Since there is blunting of left costophrenic angle, a cause due to fluid collection and irritation of pleura on the left side is the most likely possibility. This can be confirmed only after a clinical examination.

This sort of pain as described by you may even be acid reflux disease. Other common causes of such pain might be of musculoskeletal origin.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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