Cardiac Radiography > Pathology > Pathologic Conditions > Lesions Presenting with Normal Vascularity and Heart Size

Lesions Presenting with Normal Vascularity and Heart Size

If a patient presents with a normal vascular pattern and no evidence of cardiac enlargement, the diagnosis is likely to fall into one of the following groups: myocardial ischemia, increased ventricular afterload (pressure overload), or a problem with the ascending aorta. However, any of these lesions may cause chamber enlargement or an abnormal vascular pattern if the involved ventricle fails. Most of the time one will not be able to come to a definitive diagnosis, but a careful search should be made for clues such as coronary artery calcium, myocardial calcium (figure on left), or ventricular aneurysm as indicators of ischemic heart disease; a calcified aortic valve can be seen in aortic valve stenosis (figure on right).


Calcified myocardium (arrows, left) in a patient with previous myocardial infarction. Calcified aortic valve (arrows, right) in a patient with left ventricular failure secondary to critical aortic stenosis. 


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