Position of AVR and MVR
35 years old male. History of rheumatic fever.
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Aortic and mitral valves are the commonly affected by disease. The position of the cardiac valves can be inferred on both the PA and lateral chest radiograph.
On a PA chest radiograph a reference line can be drawn from the left atrial appendages to the right cardiophrenic recess. The aortic valve typically lies above this reference point and has the orifice orientated towards the left ventricular outlet/aortic root. Conversely the mitral valve is below this reference line with the orifice directed towards the left ventricle/cardiac apex.
On the lateral view a reference line drawn can be drawn from the carina to the cardiac apex. The aortic valve lies above the reference line and has the orifice directed at the left ventricular outlet/aortic root. Conversely the mitral valve is below the reference line with the orifice directed towards the left ventricle/cardiac apex.
This patient also has classic feature of upper lobe venous redistribution with increased perihilar interstitial pulmonary markings and peripheral septal lines (Kerley-B). Imaging features are consistent with raised pulmonary venous pressure and pulmonary interstitial oedema.