Comparison between Left and Right ventricular Enlargement
LATERAL EXAMINATION RVE AND LAE ? MITRAL STENOSIS PULMONARY HYPERTENSION AND COR BOVINUM 71 year old Asian female with rheumatic heart disease dominated by calcific mitral stenosis mild MR, moderate tricuspid regurgitation and secondary pulmonary hypertension. The lateral examination (a, and b) show normal ratios of the length of the retrosternal air space, (upper anterior white line 2/3, and normal 1/3 length of the anterior RV border (blue line). In images c and d the anterior overlay shows an increase in the ratio of the RV (navy blue-line to the upper 2/3 of the retrosternal space (white line) indicating RVE. Posteriorly, there is an increase ratio of the distance between the upper left atrial length (red ? of posterior border of the left atrium (LA) and the lower border of the LV (white line) indicating LAE. In addition the straight left main bronchus (b ? teal arrow) is shifted upward and is almost horizontal (d teal arrowhead) indicating LAE. Inferiorly the ratio of the length of the LV (maroon line) when compared to the rest of the diaphragm (white) is normal , indicating no evidence of LVE Ashley Davidoff MD
Isolated Left Atrial Enlargement This plain chest X-ray shows the classical features of an enlarged left atrium characterized by a double density on the right side of the heart (1), splaying of the carina (2), elevation and narrowing of the left main stem bronchus (3), prominent left atrial appendage (4), posterior displacement of the left main stem bronchus (5) as seen as the lateral examination and posterior bulging of the left atrium (6). These findings are consistent with mitral stenosis likely of rheumatic origin
Courtesy Ashley Davidoff MD copyright 2009 all rights reserved 15410c02.8s