Differential Diagnosis for Abnormal Cardiac Border on CXR
Single Most Likely Diagnosis
- Pneumonia: Unilateral abnormal cardiac border on chest X-ray (CXR) is often due to pneumonia, which can cause consolidation and obscing the normal cardiac silhouette.
Other Likely Diagnoses
- Pleural Effusion: A unilateral pleural effusion can cause an abnormal cardiac border by obscuring the normal contour of the heart.
- Atelect Desert: Atelect desert or collapse of the lung can also cause an abnormal cardiac border by altering the normal lung architecture.
- Pulmonary Mass: A unilateral pulmonary mass, such as a tumor, can cause an abnormal cardiac border by displacing or obscuring the normal cardiac silhouette.
Do Not Miss Diagnoses
- Pulmonary Embolism: Although less likely, a pulmonary embolism can cause an abnormal cardiac border, particularly if it is large and causes significant lung infarction or hemorrhage. Missing this diagnosis can be fatal.
- Tension Pneumothorax: A tension pneumothorax can cause a unilateral abnormal cardiac border and is a life-threatening emergency that requires immediate recognition and treatment.
Rare Diagnoses
- Diaphragmatic Hernia: A diaphragmatic hernia can cause an abnormal cardiac border by allowing abdominal contents to herniate into the thoracic cavity.
- Pericardial Cyst: A pericardial cyst can cause an abnormal cardiac border by displacing or obscuring the normal cardiac silhouette.
- Mediastinal Mass: A mediastinal mass, such as a lymphoma or thymboaria, can cause an abnormal cardiac border by displacing or obscuring the normal cardiac silhouette.