Hoffman-Rigler sign (heart)

The Hoffman-Rigler sign is a sign of left ventricular enlargement inferred from the distance between the inferior vena cava (IVC) and left ventricle (LV).​

Radiographic features

On a lateral chest radiograph, if the distance between the left ventricular border and the posterior border of IVC exceeds 1.8 cm, at a level 2 cm above the intersection of diaphragm and IVC, left ventricular enlargement is suggested .

Later investigators suggest this should be increased to 1.9 cm to decrease the number of false positives .

Prior to their publication in 1951, LV enlargement was suggested when the posterior LV border was more than 1.5 cm posterior to the IVC.

Practical points

Hoffman-Rigler sign should not be confused with Rigler sign, Rigler triad or Rigler notch sign.

History and etymology

Richard ("Dick") B Hoffman (1937-2011) and Leo George Rigler (1896-1979 ), American radiologists, described their eponymous sign in a paper in 1965 .