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January 1963

Radiologic Evaluation of Heart Size in Rheumatic Heart Disease: Studies in Young Patients

Author Affiliations


Associate Attending Physician, Division of Medicine, Montefiore Hospital, and Instructor in Medicine, Columbia University, New York (Dr. Frieden); Attending Physician, Division of Diagnostic Radiology, Montefiore Hospital, and Associate Clinical Professor of Radiology, New York University School of Medicine (Dr. Shapiro); formerly, Medical Director, Irvington House, and Assistant Professor of Medicine, New York University of Medicine, present address: Department of Medicine, Yale University School of Medicine, New Haven, Conn. (Dr. Feinstein).; From Irvington House, Irvington-on-Hudson, New York; The Departments of Medicine and Radiology, Montefiore Hospital, Bronx, N.Y., and The Department of Medicine, New York University School of Medicine, New York.

Arch Intern Med. 1963;111(1):44-50. doi:10.1001/archinte.1963.03620250048007

The determination of heart size is essential for ' evaluating prognosis and the need for physical limitations after an acute attack of rheumatic fever. Of the available simple techniques for measuring cardiac size, radiography is more sensitive than physical examination and is, in rheumatic heart disease, more generally useful than electrocardiography. However, radiologic examination of the heart has certain major disadvantages: (1) Measurements of the cardiac silhouette may often be affected by physiologic factors and do not provide a sharp demarcation between normal and abnormal; (2) quantitation of chamber size is done subjectively, and (3) fluoroscopy, which is usually considered better than films for assessing the effects of respiration or of cardiac contraction, is undesirable because of the need for increased radiation1,2 and the lack of a permanent record.

Despite these disadvantages, radiography continues to be the major clinical technique for appraisal of heart size. The present work was done