Chest X-Ray Interpretation

• Name: MAN MAYA RAI, 95 years, Male
• Date: 2026-05-04, 16:47
• View: PA (Chest AP)

Technical Adequacy

• Projection: AP (anteroposterior) — note this slightly magnifies the cardiac silhouette compared to a true PA
• Rotation: Minimal — clavicles are reasonably symmetric
• Exposure: Adequate; lung markings visible throughout
• Inspiration: Adequate

Systematic Review

1. Trachea & Mediastinum

• Trachea appears midline
• Mediastinum is widened, particularly in the upper and mid zones — the superior mediastinum appears prominent
• The aortic knuckle is prominent/calcified — consistent with advanced age (aortic unfolding/calcification)
• Aortic arch appears unfolded and tortuous, which is expected at age 95

2. Cardiac Silhouette

• The heart is enlarged — cardiomegaly is present (cardiothoracic ratio appears >0.5 on this AP film)
• Both right and left heart borders are visible but indistinct in some areas
• The left heart border appears prominent, suggesting possible left ventricular enlargement

3. Lungs

• There is increased interstitial markings throughout, particularly in the mid and lower zones
• Prominent perihilar opacification and vascular redistribution (upper lobe vessel prominence suggests raised pulmonary venous pressure)
• No clear consolidation — but the perihilar haziness is notable

• Similar pattern of increased interstitial/perihilar markings
• Left upper lobe/perihilar region shows increased opacity
• No obvious large pleural effusion, though the left costophrenic angle may be slightly blunted — possible small effusion

4. Hila

• Bilateral hilar prominence — consistent with pulmonary venous hypertension or hilar lymphadenopathy (less likely at this age presentation)
• The hila appear vascular in character (not lobulated)

5. Pleura

• Right costophrenic angle — appears relatively preserved
• Left costophrenic angle — appears slightly blunted, possible small left pleural effusion

6. Diaphragm

• Both hemidiaphragms are visible; right is slightly higher (normal)

7. Bones & Soft Tissues

• Aortic calcification visible (expected, age 95)
• Bony structures appear osteopenic consistent with advanced age
• No rib fractures obvious on this view

Impression

Congestive Heart Failure (pulmonary oedema / decompensated heart failure)

• Cardiomegaly
• Bilateral perihilar opacification ("bat-wing" / "butterfly" pattern)
• Vascular redistribution (upper lobe venous congestion)
• Interstitial oedema (increased bilateral lung markings)
• Possible small left pleural effusion
• Aortic unfolding and calcification (hypertensive/atherosclerotic disease)

Clinical Recommendation

• BNP/NT-proBNP — to confirm cardiac cause of fluid overload
• ECG — assess for underlying arrhythmia (AF is common in this age group)
• Echocardiogram — assess ejection fraction (HFrEF vs HFpEF)
• Renal function and electrolytes — before initiating/adjusting diuretics
• Clinical correlation — dyspnoea, orthopnoea, leg oedema, JVP elevation

⚠️ Disclaimer: This is an AI-assisted interpretation for educational and clinical support purposes only. It must be reviewed and confirmed by a qualified radiologist or clinician before any clinical decisions are made.