Globoid-shaped heart on radiograph could be due to which?

• A. Pericardial effusion & extreme generalized cardiomegaly
• B. Pulmonary edema
• C. Left atrial enlargement
• D. Normal variation

Answer: (A)

A rounded, globular cardiac silhouette on a chest radiograph most strongly points to fluid around the heart—pericardial effusion. When pericardial fluid accumulates, it surrounds the heart evenly and pushes the heart into a smooth, circular shape. In cases with more pronounced enlargement, extreme cardiomegaly can contribute to a rounder outline, but the globoid appearance is classic for pericardial effusion.

Pulmonary edema usually shows diffuse interstitial or Alveolar edema with vascular changes and does not produce a uniformly globular heart shape. Left atrial enlargement tends to alter the contour of the left heart border—often distorting the caudal border or causing leftward bulging—rather than creating a completely round silhouette. Normal variation can change heart size or shape somewhat, but a distinctly globoid contour is not typical of normal anatomy.