On chest radiograph, which finding supports dilated cardiomyopathy?

• A. Enlarged cardiac silhouette
• B. Small heart silhouette
• C. Cardiomegaly with pericardial calcification
• D. Normal heart size with mediastinal widening

Answer: (A)

Dilated cardiomyopathy causes dilation of the ventricles, leading to an enlarged heart that appears as an enlarged cardiac silhouette on a chest radiograph. This radiographic finding—cardiomegaly—is the classic clue to ventricular dilation and aligns best with DCM among the options. A small heart silhouette would suggest underfilling or hypovolemia, not dilation. Cardiomegaly with pericardial calcification points to constrictive pericarditis, while a normal-sized heart with mediastinal widening implies other thoracic pathologies such as mediastinal masses or aortic disease rather than DCM.