Presentation
Dyspnea and palpitations; diastolic murmur; past history of rheumatic fever.
Patient Data
Age: 40
Gender: Male
From the case:
Mitral stenosis
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X ray findings:
- enlarged cardiac shadow
- straightening of left heart border
- double right heart border
- splaying of carinal angle
Case Discussion
A case of mitral stenosis due to rheumatic heart disease:
- normal area of mitral valve is 4-6 cm2
- area less than 2 cm2 is considered stenotic
- x-ray findings are noted at areas <1 cm2
- left atrial enlargement causes double right heart border
- straightened left heart border is formed by (from superior to inferior):
- aortic knuckle
- prominent left pulmonary conus (due to pulmonary hypertension)
- concave left atrial appendage (normally convex)
- left ventricle shadow
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