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For many years the roentgenologists have been using 50 per cent as the limit of normal variation for the thoracic heart index. On the other hand, if the transverse diameter of the heart as obtained from a plate taken at a distance of 6 feet is 51 per cent or more of the transverse width of the thorax at its widest level (the upper part of the diaphragm), the size of the heart is considered abnormal. The author has attempted to answer these questions: How far can this index be used for diagnosis, and how variable is the relationship between the size and shape of the heart to the chest in normal children? He has perfected the technic of orthodiagraphy for use in infants as well as in children. Furthermore, he has correlated the transverse diameter of the heart in 127 children between the ages of 2 and 15 years,
Grundlagen der orthodiagraphischen Herzgrozen und Thoraxbreiten-beurteilung im Kindesalter. Am J Dis Child. 1930;40(2):459-460. doi:10.1001/archpedi.1930.01940020235019