Pulmonary edema on chest X-ray supine view. Supine view is identified by the absence of fundal gas bubble below the diaphragm. Moreover, the scapulae are seen within the lung fields, which will not be there in a well positioned chest X-ray PA view. The apparent cardiomegaly cannot be commented upon since it is a supine view.
Standard chest X-ray PA view is taken with the patient standing behind the X-ray film and the X-ray tube at a distance of 72 inches behind. At that distance, the X-ray beam is somewhat parallel and does not produce magnification of the heart as viewed from the X-ray film. In supine view the heart is more away from the X-ray film and usually the X-ray tube is much nearer to the person, producing magnification of the cardiac outline. In this era of digital X-rays, it may be noted that the image acquiring cassette does not have a film, but a sensor instead. Image is then transferred to the console for either viewing in a computer screen or printing on a film (usually of much smaller size than the conventional chest X-ray film).
A repeat chest X-ray after treatment of the left ventricular failure which caused the pulmonary edema showed complete clearance of the pulmonary congestion.