Advanced Patient Assessment Practice Exam

What might a significant increase in the cardiothoracic ratio suggest?

1. Hyperinflation of the lungs

2. Left ventricular hypertrophy

3. Pneumothorax

4. Mediastinal shift

The correct answer is: Left ventricular hypertrophy

A significant increase in the cardiothoracic ratio is commonly used as an indicator of potential cardiac enlargement, particularly left ventricular hypertrophy. This measurement compares the diameter of the heart to the diameter of the thoracic cavity on chest X-rays. When the heart appears larger relative to the thoracic cavity, it suggests that the heart muscle is thickening and enlarging due to increased workload or pressure, which is a hallmark of left ventricular hypertrophy. This condition can arise from long-standing hypertension or other forms of heart disease that cause increased afterload on the left ventricle. The other options, while they may also be seen in various cardiac or pulmonary conditions, do not typically lead to a significant increase in the cardiothoracic ratio in the same way. For instance, hyperinflation of the lungs can occur with conditions like COPD, but it doesn’t directly cause the heart silhouette to enlarge in relation to chest size. Similarly, a pneumothorax presents with different radiographic findings and is characterized by air in the pleural space rather than changes in the heart size. Lastly, a mediastinal shift, which could result from various thoracic pathologies, is indicative of shifting structures rather than direct enlargement of the heart itself. Thus,