An alerting sign: Enlarged cardiac silhouette

U. HAMIEL, S. YEGANEH, S. CARRASSO, S. SOBOH
2015 Cleveland Clinic journal of medicine  
An alerting sign: Enlarged cardiac silhouette A 75-year-old-woman with a history of hypertension and left-lung lobectomy for a carcinoid tumor 10 years ago presented with a 2-week history of progressive cough, dyspnea, and fatigue. Her heart rate was 159 beats per minute with an irregularly irregular rhythm, and her respiratory rate was 36 breaths per minute. Her blood pressure was 140/90 mm Hg. Examination revealed decreased breath sounds and dullness on percussion at the left lung base,
more » ... ft lung base, jugular venous distention with a positive hepatojugular refl ux sign, and an enlarged liver. Electrocardiography showed atrial fi brillation. Chest radiography (Figure 1 ) revealed
doi:10.3949/ccjm.82a.14185 pmid:26651888 fatcat:ypwte6ctvzdbnil4aemduu6kzm