This case demonstrates typical radiographic features of chronic mitral regurgitation (confirmed on echocardiography) including:

• convexity or straightening of the left atrial appendage along the left heart border below the main pulmonary artery due to left atrial enlargement;
• double density projecting over the right heart, reflecting superimposition of enlarged left atrium over the right heart
• elevation of the left main bronchus and splaying of the carina by enlarged left atrium
• left ventricular enlargement
• cephalization of flow due to pulmonary venous hypertension