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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Do CT Scan Showing Marked Emphysematous Changes And Borderline Cardiomegaly Mean?

70 yr old male, 2012 had heart stent put in diagnosed with heart disease and a fib. 2013 had viral pneumonia. 2013 ct scan 2 view CXR noted mild right basilar infiltrate consistent with Pneumonia. 2014, began having a mild but chronic cough which worsened and a second CT scan with contrast showed marked emphysematous changes, no lung mass or lymphadenopathy, infiltrates or effusions noted. Heart demonstrates borderline cardiomegaly. Had a pulmonary function test done with no significant findings such as obstructions. Smoked for 25 yrs. stopped 1985, was in agent orange in Vietnam. What is your best bet for a diagnosis?
Mon, 19 Dec 2022
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  Anonymous's Response
's  Response
Hi,

Your CT scan showed emphysematous changes and cardiomegaly.

1) Emphysematous changes occur most frequently in smokers and ex-smokers. It shows on scans and x-rays as having enlarged lung-area and a more barrow-shaped thorax with more space between the rips. It is not in itself dangerous, but is a finding we often see. It can also be caused and exacerbated by pollution as well as being exposed through harmful chemicals through work. I am unable to advice on agent orange being a factor here, but my guess is no.

2) Cardiomegaly - borderline. What this basically means is that your heart is enlarged, almost to the point of being pathological (as in; not normal). This is a frequent find as well, and does not indicate any health problems in at of itself, however it brings the question as to why it is large. The most obvious culprit here is high blood pressure, but there are multiple possible reasons.
I highly suggest you discuss this further with your doctor.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Maria Riechel-Sarup, General & Family Physician

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What Do CT Scan Showing Marked Emphysematous Changes And Borderline Cardiomegaly Mean?

Hi, Your CT scan showed emphysematous changes and cardiomegaly. 1) Emphysematous changes occur most frequently in smokers and ex-smokers. It shows on scans and x-rays as having enlarged lung-area and a more barrow-shaped thorax with more space between the rips. It is not in itself dangerous, but is a finding we often see. It can also be caused and exacerbated by pollution as well as being exposed through harmful chemicals through work. I am unable to advice on agent orange being a factor here, but my guess is no. 2) Cardiomegaly - borderline. What this basically means is that your heart is enlarged, almost to the point of being pathological (as in; not normal). This is a frequent find as well, and does not indicate any health problems in at of itself, however it brings the question as to why it is large. The most obvious culprit here is high blood pressure, but there are multiple possible reasons. I highly suggest you discuss this further with your doctor. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Maria Riechel-Sarup, General & Family Physician