DIFFERENTIAL DIAGNOSIS OF TRUE CARDIOMEGALY AND PERICARDIAL EFFUSION: THE VALUE OF THE CARDIOTHORACIC INDEX ON A CHEST RADIOGRAPH
DOI:
https://doi.org/10.32782/3083-7324/2025.2.5Keywords:
cardiothoracic index, differential diagnosis, cardiomegaly, pericardial effusion, chest radiography, cardiac tamponade, echocardiography.Abstract
The article discusses the role of cardiothoracic index (CTI) in the differential diagnosis of true cardiomegaly and cardiac shadow enlargement caused by pericardial effusion. Despite the development of modern imaging methods, chest radiography remains the most accessible method of primary diagnosis, and CTI is a key screening indicator. Radiological differenti- ation criteria are analyzed: true cardiomegaly is characterized by a gradual increase in CTI and the presence of pulmonary venous congestion, while pericardial effusion is characterized by a rapid increase in CTI, the formation of a “bulb-shaped” cardiac shadow, and the absence of congestion. Special attention is paid to the rate of change of CTI as a critical diag- nostic indicator reflecting the pathophysiology of fluid accumulation in the pericardium. It is emphasized that a normal CTI does not exclude acute cardiac tamponade, and the diagnosis requires confirmation by echocardiography.
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