Patient seems mildly exercise intolerant to the family, but has also gained 3 lbs over the past 12 months. Patient has no history of cardiopulmonary disease previously.

Notre Dame's right lateral radiograph

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Notre Dame's ventral-dorsal radiograph

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Technical details
Location of images: Thoracic radiographs obtained.
Views of images: Right lateral and ventrodorsal views. Radiographic findings 
Technical issues: Good, but could be collimated to exclude the abdomen.
Cardiac size including VHS: VHS 8.0. Cardiac silhouette appears mildly elongated, but a closer inspection reveals a lighter density in the pericardiacophrenic ligament and along the sternum that is suspected to be fat. The rest of the cardiac silhouette appears normal. Cardiac silhouette appears to be somewhat globoid and enlarged, but no specific chamber enlargement is identified. There is however a ring of a slightly lighter radiographic density around the silhouette, most pronounced over the left ventricle and left atrial appendage, but also present on the right side, a density consistent with adipose tissue overlying a soft tissue density (cardiac silhouette). No pulmonary venous congestion or arterial distension. Pulmonary infiltrate distribute diffuse. Pulmonary infiltrate pattern, very mild diffuse bronchial pattern.
Other findings: An echocardiogram was performed and revealed normal cardiac size with pericardial, epicardial and sternal fat. Normal cardiac structures with excessive epicardial and pericardial fat.
Radiographic interpretations: Normal cardiac structures with excessive epicardial and pericardial fat.