Presentation
Elderly patient with a long history of cardiac disease.
Patient Data
![](https://prod-images-static.radiopaedia.org/images/5489397/57eda089e2e481546f9453377fb441_big_gallery.jpg)
Median sternotomy and MVR.
The subcarinal angle is splayed to 150 degrees ( usually less than 90 degrees).
Double right heart border from normal right atrium and enlarged left atrium.
Enlarged left atrial appendage.
Cardiomegaly, but no overt signs of cardiac failure.
Case Discussion
Mitral stenosis gives a number of classical chest radiograph appearances all shown in this film, although with evidence of subsequent mitral valve replacement.
Radiographic signs of a mitral heart are:
double right heart border - due to enlargement of the left atrium
prominent left atrial appendage
splaying of the subcarinal angle (150 degrees) - due to compression from the enlarged left atrium