Tricuspid and mitral valves disease

Case contributed by Melbourne Uni Radiology Masters


Shortness of breath.

Patient Data

Age: 87-year-old
Gender: Female

Chest radiograph

AP and lateral projections. Comparison made with the previous chest x-ray.

Massive enlargement of the cardiac silhouette is stable. Sternal wires, prosthetic mitral valve and single lead right-sided pacemaker device are also again noted. Stable contour of the thoracic aorta. No focal region of consolidation is identified. Minor interstitial opacity within the lower zones and blunting of the posterior costophrenic angles are stable.


CT Chest

There is massive cardiomegaly with extreme dilatation of the right and left atria. Prosthetic mitral and tricuspid valves. Single lead pacemaker with tip in the right ventricle. There is marked dilatation of the pulmonary veins. Pulmonary arteries are enlarged. No thoracic lymphadenopathy.

There is left lower lobe consolidation and subtle bilateral perihilar ground glass attenuation with increased interstitial markings in the bases. Tiny left pleural effusion.

Conclusion: There is lower lobe consolidation, likely infective. Perihilar ground glass change suggests a degree of fluid overload. Background massive cardiomegaly with a pattern in keeping with a multi-valvular (tricuspid and mitral) disease.

Case Discussion

PA and lateral radiographs confirm gross enlargement of the left atrium and also the right atrium.

Cardiomyopathy could give a similar appearance.

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Case information

rID: 38469
Published: 21st Nov 2015
Last edited: 14th Aug 2019
System: Chest, Cardiac
Tag: rmh
Inclusion in quiz mode: Included

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