Despitc continuing advances in cardiovascular imaging technology, the chest radiograph rightly retains its place as a key cardiac diagnostic tool and as a simple means of following disease progression and treatment effect. Over the 2 decades since writing the original handbook version of this text, it has been my impression that proficiency with the chest radiograph has not withstood the test of time well and has suffered under the distraction of other newer forms of imaging.
The chest radiograph yields clinically useful information in the management of many patients and may often yield clinically unsuspected information. The incremental information provided by the radiographic depiction of the pulmonary parenchyma and pleura to that of clinical assessment is highly relevant and contributory toward the optimal assessment and management of the cardiology patient population. . In writing this book to encourage development during cardiology fellow training, my goal was threefold:
1. To provide a systematic approach to the review of frontal and lateral chest radiographs
2. To foster an appreciation of radiographic signs of disease
3. To impart an awareness of the typical radio-graphic findings of common and interesting acquired and congenital cardiovascular diseases
As well, I wanted to maintain the practical nature of the handbook on which this book is based while integrating some intriguing and unusual topics for the sake of interest. The origin of the handbook was my set of study notes from when I was a resident in training, a short 2 decades ago. I initially wrote a set of notes so as to not lose track of the many "pearls" that I had been taught while in training, and therein is the intended spirit of the book—the development, especially of cardiology trainees, and, I hope as well, of other trainees and of those in established practice in the care of patients with cardiovascular disease.
ACKNOWLEDGMENTS
To my former mentors and colleagues at McGill University, especially Jim Stewart, MD, whose disciplined clinical excellence and proficiency with the chest radiograph were inspiring examples of insight into disease, clinical reasoning, and the utility of diagnostic imaging in clinical medicine, and John H. Burgess, MD, whose superb clinical acumen, alacrity, and analytical approach were as inspiring. I am indebted to both of them for their openness and generosity in communicating their knowledge, their encouragement, and as well for their wonderful example as physicians that set the standard that I sought to live up to.
WITH SINCERE APPRECIATION
Abdulelah al-Mobeirek, MD; Nanette Alvarez, MD; Natasha Andjelkovic, PhD; Jehangir Appoo, MD; Graham Boag, MD; John H. Burgess, MD; Patrick Champagne, MD; Kanu Ghattcrjeee, MD; Anson Cheung, MD; Robert J. Chisholm, MD; Paul Chong, MD; Michael S. Connelly, MD; Frank Dickc, MD; Tracy Elliot, MD; Bahaa Fadcl, MD; Marie Faughnan, MD; Jason Field; Bryan Har, MD; Joyce Harder, MD; Eric Herget, MD; Ross Hill, MD;'Eric Horlick, MD; Jonathon Howlett, MD; Michael Kanakos, MD; Bruce Klanke; Anne Lennehan; Vince Lo, BSc, PT; Carmen Lydell, MD; J. H. MacGregor, MD; Brad McIlwain; Naeem Merchant, MD; Juan-Carlos Monge, MD; David Patton, MD; Susan Pioli; Bill Parmlcy, MD; Tim Prieur, MD; Mark Rabinovitch, MD; Myra Rndakcwich, MSc; Rob Sevick, MD; Gordon Snell; James A. Stewart, MD; Glen Summer, MD; Inga Tomas; John Webb, MD; Joel Wolkowicz, MD; Jason Wong, MD; and Sayeh Ziclke, MBA, MD. Stuart J. Hutchison, MD, FRCPC, FARC, FAHA

1 First Things First 1

2 The Frontal Chest Radiograph 7

3 The Lateral Chest Radiograph 20

4 Assessment of Heart Size 32

5 Pulmonary Vasculature and Pulmonary Embolism 36

6 Heart Failure 69

7 The Thoracic Aorta 81

8 Localizing Prosthetic Valves 118

9 Mechanical Prosthetic Valves 121

10 Bioprosthetic Valves 136

11 Annuloplasty Rings 147

12 Prosthetic Valve Dysfunction 155

13 Percutaneous Heart Valves, Aortic and Other Stents, and Other Interventional Hardware 159

14 Radiographic Findings by Diagnosis: Cardiomyopathies 184

15 Radiographic Findings by Diagnosis: Valvular Heart Disease 190

16 Radiographic Findings by Diagnosis: Pericardial and Pleural Diseases 217

17 Radiographic Findings by Diagnosis: Coronary Artery Disease—Complications of Infarction 257

18 Radiographic Findings by Diagnosis: Congenital Heart Disease—Shunts and Closure Devices 261

19 Radiographic Findings by Diagnosis: Congenital Abnormalities and Obstructions—Pulmonary Stenosis and Coarctation of the Aorta 297

20 Radiographic Findings by Diagnosis: Situs and Complex Congenital Abnormalities 310

21 Radiographic Findings by Diagnosis: Other Congenital Abnormalities 328

22 Central Venous and Pulmonary Artery Catheters 337

23 Pacemakers and Implantable Cardioverter Defibrillators 349

24 Percutaneously and Surgically Inserted Ventricular Assist Devices 372

25 Tubes and Drains 387

26 Postoperative Patients in the Intensive Care Unit 402

27 Cardiac and Vascular Calcification 405

28 Cardiac and Vascular Trauma 425

29 Clinical Uses of the Chest Radiograph 432

Index 435

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