If we were to “crack open” the chest of the chest X-ray, the structures that would dominate this bloody, black and white scene, would be the right sided chambers. The right ventricle (RV) would be the dominant anterior chamber, and would form the dominant interface with the diaphragm. The right atrium (RA) would form the border with the right lung. The RA would of course be slightly posterior to the RV. The left border would be formed by the left ventricle. Most the left ventricle is hidden posteriorly in this view. The left anterior descending artery would be visible from this anterior view. It marks the position of the interventricular septum.
Ashley Davidoff MD
A methodical approach to evaluation of the cardiac silhouette is likened to skiing down a mogul laden ski slope and then taking a trip on the ski lift back to the top of the mountain. The ski slope starts at the left subclavian artery (light brown), followed by the mogul of the aortic knob (bright green) at the bottom of which is the A-P window (white) only to be presented with a second mogul of the main pulmonary artery(yellow), and then the bay of the left atrial appendage (pink)and finally free at last of moguls and an exciting and accelerating ski down the LV (red)
We then have to take a walkback to the ski lift. At tthe junction of the LV (red) and the RV (blue) , if we take a right ward look up the mountain we can spot the LAD on top of the interventricular septum.
The walk along the border of the RV is terminated at the junction of the RV (dark blue) and the right atrium (light blue). At this point we wait in line to get on to the ski lift. We ride up the right hand border of the right atrium (light blue) a little rough bump over the ascending aorta )maroon) and then straight to the top along the SVC (pink).
Ashley Davidoff MD