Evidence of an enlarged left ventricle can be as follows:
a) displacement of cardiac apex inferiorly and posteriorly
b) boot shaped heart
c) Rigler’s sign (on the lateral film, from the junction of IVC and heart at the level of the diaphragm, measure 1.8 cm posteriorly and then 1.8 cm superiorly. If the cardiac shadow extends beyond this point then LV enlargement is suggested
