Presentation
Cardiac patient. Prior mitral valve replacement. Dyspnea.
Patient Data
Age: 75 years
Gender: Male
From the case:
Mitral heart
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Median sternotomy and MVR.
Severe cardiomegaly with a water bottle morphology of the heart. Severe splaying of the subcarinal angle, in keeping with left atrial enlargement.
Lungs clear. No signs of cardiac failure.
Case Discussion
Even though this is an AP projection there is no doubt the heart is huge.
Check out the subcarinal angle on this patient which is 160 degrees due to the enlarged left atrium below splaying it.
Proof of prior mitral stenosis is evident in the form of a mitral valve replacement (which is open at the time of the image acquisition).
The water bottle heart appearance is more usually associated with a pericardial effusion.