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Walking Man with A Large Heart |
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Raghavendra Bhat, Parul Kodan, Meenakshi Shetty 1. Professor and Head, Department of Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India. 2. Post Graduate Student, Department of Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India. 3. Associate Professor, Department of Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India. |
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Correspondence Address : Dr. Raghavendra Bhat, Head of the Department ,Department of Medicine, Kasturba Medical College, Mangalore, Karnataka, India. E-mail: nita2005bhat@yahoo.co.in |
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| INTRODUCTION |
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Enlargement of left atrium acts as a predictor of cardiovascular outcomes such as atrial fibrillation, stroke, congestive heart failure, cardiovascular death and also reflects diastolic burden (1). Although echocardiogram acts as an accurate tool to precisely measure left atrial enlargement in most clinical setup, the treating physician in less equipped setup can get loads of information by carefully looking at the black and white image of chest roengtogram. This cheap imaging tool may show double density sign, enlarged carinal angle (2) and the lateral view may beautifully depict a walking man (Table/Fig 1). The Chest X Ray can thus act as preliminary tool to give the clue for left atrium enlargement. Posterior displacement of left main bronchus due to left atrial enlargement, gives an image of inverted V, which mimics the legs of a walking man (3). Our image shows this classical walking man sign in a patient with long standing mitral stenosis (Table/Fig 2) (a,b). Chest X-Ray Lateral View showing Walking Man Sign due to left atrial enlargement. LEARNING POINT OVERVIEW • Strong evidence suggests that left atrial enlargement has clinical significance in patient with cardiovascular disease. • Chest X-ray can give clue to the physician about left atrial enlargement. • Walking man sign is a classical sign of left atrial enlargement seen in chest X ray lateral view. | |||||||||
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