Echocardiography and enlarged cardiothoracic ratio
Dear Sirs,
The Guys’ and St Thomas’s echo team are to be congratulated on producing evidence-based advice that could result in a significant reduction in cardiac ultrasound referrals, which may be enhanced if our radiology colleagues are taken on board.1 Many years ago, our echo department was overloaded with requests for studies as a consequence of radiology reports that included the emotive term ‘cardiomegaly’. This expression is, of course, speculative, as enlargement of the ‘cardiac’ shadow may be due to an expiratory radiograph, prominent epicardial fat pads, pericardial effu