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What Does The Following X-ray Report Suggest?
Question: Dear Doctor,
Last week I undertook a Medical Examination for a Job entry with the United Nations.
My X-Ray Report was as follows:-
• Lung fields show normal features, with normal symmetry, vascularity and interstitial markings;
• The mediastinum is not enlarged and the bronchi show normal features;
• The cardiac silhouette is enlarged and the cardio-thoracic ratio is above the normal range (16.5/32);
• There is no hilar dilatation/enlargement;
• The inspiration is full and the costo-phrenic angles are sharp;
• No focal and/or diffuse masses, no nodules, no bronchial cuffing and no infiltration seen. The bones are within normal limits;
CONCLUSION:
• Features are suggestive of moderate cardiomegaly
My other readings are as follows:
• Height: 163cm
• Weight: 92kg
• BP: 136/86
• Pulse: 77
• Visual Acuity: SL - 10/10; OD – 10/10
I am worried about the X-Ray Report conclusions. What does it mean to have “moderate cardiomegaly?” How serious is this? Is it likely to affect the decision to be employed or not?
What remedies can I take to correct this problem?
I would be very grateful of your help
Yours, XXXXXXX
Last week I undertook a Medical Examination for a Job entry with the United Nations.
My X-Ray Report was as follows:-
• Lung fields show normal features, with normal symmetry, vascularity and interstitial markings;
• The mediastinum is not enlarged and the bronchi show normal features;
• The cardiac silhouette is enlarged and the cardio-thoracic ratio is above the normal range (16.5/32);
• There is no hilar dilatation/enlargement;
• The inspiration is full and the costo-phrenic angles are sharp;
• No focal and/or diffuse masses, no nodules, no bronchial cuffing and no infiltration seen. The bones are within normal limits;
CONCLUSION:
• Features are suggestive of moderate cardiomegaly
My other readings are as follows:
• Height: 163cm
• Weight: 92kg
• BP: 136/86
• Pulse: 77
• Visual Acuity: SL - 10/10; OD – 10/10
I am worried about the X-Ray Report conclusions. What does it mean to have “moderate cardiomegaly?” How serious is this? Is it likely to affect the decision to be employed or not?
What remedies can I take to correct this problem?
I would be very grateful of your help
Yours, XXXXXXX
Brief Answer:
Everything seems to be within normal ranges: so, relax!
Detailed Answer:
Hello dear XXXX!
I understand your concern, and would like to explain that there is nothing to worry about.
Everything from your uploaded medical tests seems to be normal; no any evidences to affect your employment.
Regarding your chest X ray study, all the reported features result within the normal range (normal lung vascularity, normal parenchyma, normal mediastinum and thoracic cage structures, etc).
More specifically your cardiothoracic index (ratio) is around 0.5, while the accepted normal range is <0.5. This doesn't mean that you have cardiomegaly (that is an enlarged heart), as this ratio is affected by several other usual findings like a prominent epicardial fat (more frequent in over-weighted individual as you are), or when the exam is taken when on expiration.
Other reasons like a pericardial effusion may be responsible (but I don't believe it in your case). So that slight cardiothoracic ratio increase (in fact a borderline) is in reality a false alarm.
Remember that cardiothoracic ration is a coarse tool in judging about cardiac dimensions.
In fact, if you wish to clarify this uncertainty, I recommend you to perform a cardiac ultrasound, which is the appropriate test for investigating cardiac structure and function and to definitely alleviate the anxiety raised by this issue.
I recommend you to control your body weight, if you wish to improve (decrease) this ratio.
Hope to have been helpful to you!
Feel free to ask me whenever you need!
Best regards,
Dr. Iliri
Everything seems to be within normal ranges: so, relax!
Detailed Answer:
Hello dear XXXX!
I understand your concern, and would like to explain that there is nothing to worry about.
Everything from your uploaded medical tests seems to be normal; no any evidences to affect your employment.
Regarding your chest X ray study, all the reported features result within the normal range (normal lung vascularity, normal parenchyma, normal mediastinum and thoracic cage structures, etc).
More specifically your cardiothoracic index (ratio) is around 0.5, while the accepted normal range is <0.5. This doesn't mean that you have cardiomegaly (that is an enlarged heart), as this ratio is affected by several other usual findings like a prominent epicardial fat (more frequent in over-weighted individual as you are), or when the exam is taken when on expiration.
Other reasons like a pericardial effusion may be responsible (but I don't believe it in your case). So that slight cardiothoracic ratio increase (in fact a borderline) is in reality a false alarm.
Remember that cardiothoracic ration is a coarse tool in judging about cardiac dimensions.
In fact, if you wish to clarify this uncertainty, I recommend you to perform a cardiac ultrasound, which is the appropriate test for investigating cardiac structure and function and to definitely alleviate the anxiety raised by this issue.
I recommend you to control your body weight, if you wish to improve (decrease) this ratio.
Hope to have been helpful to you!
Feel free to ask me whenever you need!
Best regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
Thank you so much for your reassuring response. It helped me lessen my worries.
Further on the same matter, it seems that the Doctors working on my Medical clearance have decided to pend the clearance waiting for a further report from a cardiologist. I today received the following message directed to the Doctor who undertook to conduct the exam on me:-
Message from Dr. XXXXXXX Shikara
"... Dear Dr. Tima,
Thank you for sending us the medical exam for Mr. XXXX.
In order for us to further evaluate your clearance, please refer him for consultation with a Cardiologist and send us the consultation report.
Your kind assistance in this matter is much appreciated, medical clearance for the above will be pending in the meantime.
Best regards,..."
QUESTIONS:
What could be the Cardiologist's findings? What could they be looking for?
Is there anything I can do to improve my assessment with the Cardiologist in next 3 days (I plan to see him Monday or Tuesday);
What remedies can consider to improve this situation, and also ensure the better health especially my heart, if any?
I would really appreciate your help,
XXXX
Thank you so much for your reassuring response. It helped me lessen my worries.
Further on the same matter, it seems that the Doctors working on my Medical clearance have decided to pend the clearance waiting for a further report from a cardiologist. I today received the following message directed to the Doctor who undertook to conduct the exam on me:-
Message from Dr. XXXXXXX Shikara
"... Dear Dr. Tima,
Thank you for sending us the medical exam for Mr. XXXX.
In order for us to further evaluate your clearance, please refer him for consultation with a Cardiologist and send us the consultation report.
Your kind assistance in this matter is much appreciated, medical clearance for the above will be pending in the meantime.
Best regards,..."
QUESTIONS:
What could be the Cardiologist's findings? What could they be looking for?
Is there anything I can do to improve my assessment with the Cardiologist in next 3 days (I plan to see him Monday or Tuesday);
What remedies can consider to improve this situation, and also ensure the better health especially my heart, if any?
I would really appreciate your help,
XXXX
Brief Answer:
A cardiac ultrasound would definiely clarify this issue.
Detailed Answer:
Hi again dear XXXX!
As I explained you before, the best strategy to clarify this issue (presence of cardiomegaly) is by performing a cardiac ultrasound.
I believe that having that cardiac exam, will help your cardiologist rule in/out any possible cardiac chamber enlargements, quatify its function (systolic and diastolic), or investigate potential causes if any changes is abserved.
There is nothing you can do to inlfuence cardiac tests results.
Just try to relax for the next days!
As you have no obvious symptomatology (no clinica lsigns and symptoms of heart failure, no cardiac arrhythmia, no additional remedies should be considered. Keep following a healthy diet and life style.
After having the cardiologist check up, and the cardiac ultrasound too, please let me know about the results.
Kind regards,
Dr. Iliri
A cardiac ultrasound would definiely clarify this issue.
Detailed Answer:
Hi again dear XXXX!
As I explained you before, the best strategy to clarify this issue (presence of cardiomegaly) is by performing a cardiac ultrasound.
I believe that having that cardiac exam, will help your cardiologist rule in/out any possible cardiac chamber enlargements, quatify its function (systolic and diastolic), or investigate potential causes if any changes is abserved.
There is nothing you can do to inlfuence cardiac tests results.
Just try to relax for the next days!
As you have no obvious symptomatology (no clinica lsigns and symptoms of heart failure, no cardiac arrhythmia, no additional remedies should be considered. Keep following a healthy diet and life style.
After having the cardiologist check up, and the cardiac ultrasound too, please let me know about the results.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor,
Thank you for your response. I will undertake the tests as advised and revert to you with the results
Kind regards
XXXXXXX
Thank you for your response. I will undertake the tests as advised and revert to you with the results
Kind regards
XXXXXXX
Brief Answer:
You are welcome!
Detailed Answer:
Dear XXXXXXX
I will be at your disposal whenever you need!
Wishing you a pleasant weekend!
Kind regards,
Dr. Iliri
You are welcome!
Detailed Answer:
Dear XXXXXXX
I will be at your disposal whenever you need!
Wishing you a pleasant weekend!
Kind regards,
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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