Evaluation of cardiomegaly on chest x-ray

Review history
Examination
ECG

Evaluate for:

Valvular heart disease
Coronary artery disease
Cardiomyopathy

Consider right heart failure secondary to left heart failure from various causes of left ventricular dilation

No further workup

? Pericardiocentesis

Consider:

CT
MRI
Surgery/biopsy

Evaluate for:

Pulmonary emboli
Mitral stenosis
Primary pulmonary hypertension
Eisenmenger's syndrome

Evaluate for:

Atrial septal defect
Tricuspid regurgitation

End

R/O tamponade

? Cause

Pulmonary hypertension?

Yes

No

Echocardiogram

Left ventricular dilation

Biventricular dilation

Right ventricular dilation

Pericardial effusion

Pericardial thickening

Pericardial mass

No abnormalities