Key result
The apparent reduction in frontal transcardiac diameter in uncomplicated obstructive emphysema is a logical consequence of the vertical position of the heart rather than a true reduction in volume.
Highlights that the apparent reduction in frontal transcardiac diameter in obstructive emphysema is a positional artifact, with total heart volume remaining commensurate with weight.
To the Editor:— The recent article, Heart Size in Pulmonary Emphysema by Baratto and Muehsam ( 203 :293, 1968), again raises the question of the significance of measurements of the greatest horizontal transcardiac diameter in the frontal projection, on standard 72-inch chest roentgenograms, whether expressed as absolute linear dimension or in relation to horizontal transpleural dimensions. First of all, from a purely logical point of view, there is neither mystery nor illusion in the obvious reduction in frontal transcardiac diameter usually noted in uncomplicated obstructive emphysema relative to normal patients of comparable stature, weight, sex, age, etc, in the face of similar postmortem heart weights. A simple glance at a good lateral x-ray film will re= assure one that, allowing for differences in intracardiac blood volume, the total heart volume remains commensurate with its weight. More striking roentgenologically and, perhaps, more pertinent biologically, is the vertical position of the heart, the
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John H. Feist (1968) conducted a letter in Pulmonary emphysema. The apparent reduction in frontal transcardiac diameter in uncomplicated obstructive emphysema is a logical consequence of the vertical position of the heart rather than a true reduction in volume.
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