The Differentiation of Dextroversion from Dextroposition of the Heart and Their Relation to Pulmonary Abnormalities  S. Rogel, M.D., A. Schwartz, M.D., J. Rakower, M.D., F.C.C.P.  Diseases of the Chest  Volume 44, Issue 2, Pages 186-192 (August 1963) DOI: 10.1378/chest.44.2.186 Copyright © 1963 The American College of Chest Physicians Terms and Conditions

FIGURE 1 The greater part of an enlarged heart lies in the right hemithorax. The apex is not discernible. The aortic knob is in its usual location, and a large pulmonary segment is seen below it. The hilar and peripheral pulmonary arteries are wide. The lungs are normal (Cáse 1). Diseases of the Chest 1963 44, 186-192DOI: (10.1378/chest.44.2.186) Copyright © 1963 The American College of Chest Physicians Terms and Conditions

FIGURE 2 This exposure shows the right ventricle in front of the right atrium. Both these chambers are to the right of the midline. Note the direction of the outflow tract of the right ventricle, and that of the main pulmonary artery ascending from the right to left (Case 1). Diseases of the Chest 1963 44, 186-192DOI: (10.1378/chest.44.2.186) Copyright © 1963 The American College of Chest Physicians Terms and Conditions

FIGURE 3 The greater part of an enlarged heart lies in the right hemithorax, with the apex above the right diaphragm. The dilated aorta is on the left. The lungs are oligemic (Case 2). Diseases of the Chest 1963 44, 186-192DOI: (10.1378/chest.44.2.186) Copyright © 1963 The American College of Chest Physicians Terms and Conditions

FIGURE 4 Electrocardiogram of Case 3. Note the high R waves around the sternum and the decreasing voltage in the other chest leads taken from the left and right precordium. Diseases of the Chest 1963 44, 186-192DOI: (10.1378/chest.44.2.186) Copyright © 1963 The American College of Chest Physicians Terms and Conditions

FIGURE 5 Note the pronounced asymmetry of the chest. The heart shadow is entirely in the right hemithorax (Case 3). Diseases of the Chest 1963 44, 186-192DOI: (10.1378/chest.44.2.186) Copyright © 1963 The American College of Chest Physicians Terms and Conditions

FIGURE 6 AP Bucky film shows the anomalous pulmonary vein receiving numerous tributaries in its caudad course. This vein apparently drains the whole hypoplastic right lung. No other pulmonary vessels are visible (Case 3). Diseases of the Chest 1963 44, 186-192DOI: (10.1378/chest.44.2.186) Copyright © 1963 The American College of Chest Physicians Terms and Conditions

FIGURE 7 Bronchogram. The right upper bronchus terminates in a blind end. The lower lobe bronchus shows irregular contour. No middle lobe is visible. The bronchus of Nelson is stretched and branches in the upper lung field (Case 3). Diseases of the Chest 1963 44, 186-192DOI: (10.1378/chest.44.2.186) Copyright © 1963 The American College of Chest Physicians Terms and Conditions

FIGURE 8 The right hemithorax is smaller than the left. The heart and the mediastinum are shifted to the right. The apex is on the left. An anomalous pulmonary vein is visible near the right heart border, disappearing beyond the heart shadow (Case 4). Diseases of the Chest 1963 44, 186-192DOI: (10.1378/chest.44.2.186) Copyright © 1963 The American College of Chest Physicians Terms and Conditions

FIGURE 9 AP tomograms show the large anomalous pulmonary vein running in a semicircle and disappearing below the diaphragm (Case 4). Diseases of the Chest 1963 44, 186-192DOI: (10.1378/chest.44.2.186) Copyright © 1963 The American College of Chest Physicians Terms and Conditions

FIGURE 10 The right hemithorax is shrunken. The right pleura is markedly thickened. The mediastinum and the heart are shifted to the right. The apex is on the left side. The appearance is typical for a fibrothorax (Case 6). Diseases of the Chest 1963 44, 186-192DOI: (10.1378/chest.44.2.186) Copyright © 1963 The American College of Chest Physicians Terms and Conditions