The right heart shadow is not visible on your patient's chest radiograph. Which of the following pathologies may explain this?
a. Right middle lobe pneumonia
b. Right lung pneumothorax
c. Bilateral emphysema
d. Bleb in the right lower lobe
ANS: A
The structures visible on a chest radiograph are seen only when tissue of one density is next to tissue of another density. For example, the heart is visible as a soft tissue density in the middle of the chest because the lungs, which are primarily air density, normally surround it. If the chest on either side of the heart was filled with water (pulmonary consolidation or pleural effusion), the normal heart shadow would not be visible on the radiograph.
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