Mitral heart

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Rheumatic fever as a child. Known mitral stenosis. Short of breath.

Patient Data

Age: 80 years
Gender: Female
x-ray

Even allowing from projection the heart is enlarged.

Double right heart border, due to enlargement of the left atrium.

Prominent left atrial appendage.

Severe splaying of the subcarinal angle (150 degrees).

Case Discussion

A 'full house' of signs of a mitral heart:

  1. cardiomegaly
  2. double right heart border - due to enlargement of the left atrium
  3. prominent left atrial appendage
  4. severe splaying of the subcarinal angle (150 degrees) - due to compression from the enlarged left atrium

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