Cardiomegaly - mitral regurgitation

Case contributed by Dr Liter Nguri

Presentation

Complain of breathing difficulty

Patient Data

Age: 55 years
Gender: Female

Frontal chest radiograph reveals cardiomegaly with splaying of the carina. Lung zones are clear. Both hila are normal. There is no pleural effusion. The domes of the diaphragm are normal in position and show a smooth outline. The bony thorax is normal.

Case Discussion

Mitral regurgitation is a common valvular disorder in which blood flows back from the left ventricle to the left atrium during ventricular contraction.
This case demonstrates cardiomegaly with dilated left atrial and ventricular shadows as evidenced by double right heart border sign and downward projection of cardiac apex respectively.

Echocardiography of the same patient revealed;

  • Moderate to severe mitral regurgitation
  • Dilated left atrium and left ventricle
  • Severe left ventricle systolic dysfunction,
  • Left ventricular ejection fraction of 25 to 30%
  • No clot/embolism or vegetation seen.

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