Which of the following findings on the chest film suggests a more severe case of emphysema?

Question

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Excessive vascular tapering is a classic radiographic feature of emphysema, representing a loss of elastin in the lung tissue, causing the destruction of small airways and capillary bed loss. This finding indicates a more severe case of emphysema. An enlarged right ventricle (A) and vertical positioning of the heart (B) are typically associated with chronic obstructive pulmonary disease (COPD), including emphysema, but they do not necessarily indicate the severity of the disease. Horizontal positioning of the clavicles (D) is a normal finding, not related to emphysema severity.

Which of the Following Findings on the Chest Film Suggests