The reliability of the routine chest roentgenogram for determination of heart size based on specific ventricular chamber evaluation at postmortem.

Routine posteroanterior and lateral chest radiographs in 268 patients were analyzed to determine heart size--normal, cardiomegaly, or specific chamber enlargement--using specified radiographic criteria for enlargement. The accuracy of this determination was compared with a specific ventricular mass derived from a postmortem cardiac chamber partition technique. The data indicate that in the majority of cases (greater than 70%) a normal-sized heart or cardiomegaly can be correctly determined from the chest x-ray either by the subjective criteria of chamber enlargement or by measurement of the transverse diameter. The use of the chest x-ray, however, for evaluation of specific ventricular chamber enlargement is a less accurate determination, and results are compromised.