left ventricular enlargement

Left ventricular enlargement can be the result of a number of conditions, including:

pressure overload
- hypertension
- aortic stenosis
volume overload
- aortic regurgitation
- mitral regurgitation
wall abnormalities
- left ventricular aneurysm
- hypertrophic cardiomyopathy

Radiographic features

Plain radiograph

Features that may be visible on a chest radiograph include:

left ventricular dilatation: left heart border is displaced leftward, inferiorly and posteriorly
left ventricular hypertrophy: may show rounding of the cardiac apex
Hoffman-Rigler sign
Shmoo sign

Echocardiography

The parasternal long axis and apical four-chamber views on transthoracic echocardiography are often the primary views used to gain both a qualitative and quantitative appreciation of left ventricular enlargement.
Features include :

increased left ventricular internal end-diastolic diameter (LVIDd)
- parasternal long axis LVIDd >5.3 cm (females) or >5.9 cm (males)
elevated left ventricular volumes
- diastolic volumes >104 mL (females) or >155 mL (males)
- systolic volumes >49 mL (females) or >58 mL (males)
increasingly spherical morphology
- a normal left ventricle has prolate ellipsoidal morphology, with a long axis roughly twice that of the short axis
- with severe LV enlargement the short axis dimensions may approximate those of the long axis, akin to a sphere