Mitral regurgitation chest x-ray: Difference between revisions

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{{Mitral regurgitation}}
{{CMG}}; {{AE}} {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.


'''Associate Editor-In-Chief:''' {{CZ}}; [[Varun Kumar]], M.B.B.S.; [[Lakshmi Gopalakrishnan]], M.B.B.S.
==Overview==
The [[chest X-ray]] in individuals with chronic [[mitral regurgitation]] (MR) is characterized by the presence of an enlargement of the [[left atrium]] and the [[left ventricle]].  In acute MR, [[pulmonary edema]] is present and the heart is not enlarged.


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==Chest X Ray ==
*In acute MR, [[chest X-ray]] reveals [[pulmonary edema]] caused by pulmonary congestion secondary to the abrupt rise in pressure in the [[left atrium]].  There is no enlargement of the cardiac silhouette in acute MR.<ref name=MR> Mitral regurgitation https://radiopaedia.org/articles/mitral-valve-regurgitation (2016) Accessed on December 13, 2016 </ref>


[[Image:mitral-valve02.jpg||160px|right|Calcification of the mitral annulus]]
*In chronic MR, the pulmonary vascular markings are typically normal since the pulmonary venous pressures are usually not significantly elevated. The left side of the heart might be enlarged. The left main [[bronchus]] can be pushed up by an enlarged [[left atrium]].
The chest [[x-ray]] in individuals with chronic mitral regurgitation is characterized by enlargement of the left atrium and the left ventricle.  The pulmonary vascular markings are typically normal, since pulmonary venous pressures are usually not significantly elevated.


'''Calcification of the mitral annulus''' is not infrequent, seen in up to 35% of elderly patients on echocardiography which is more sensitive than CXR. It typically begins around the margins of the posterior leaflet forming a “C” (as in this case) - eventually with anterior leaflet involvement the “C” closes forming an “O”.
*[[Calcification]] of the mitral annulus is not infrequent, and is seen in up to 35% of elderly patients on [[echocardiography]] which is more sensitive than [[chest X-ray]]. It typically begins around the margins of the posterior leaflet forming a “C”, eventually the “C” closes forming an “O” with anterior leaflet involvement. [http://www.radpod.org/2007/05/25/mitral-annulus-calcification/])[[Image:mitral-valve02.jpg||250px|center|Calcification of the mitral annulus]]<br clear="left"/>
 
Although it is associated with mitral regurgitation this is of usually trivial amounts. As opposed to aortic valve calcification, calcification of the mitral annulus is not significantly associated with stenosis of the valve and contrary to previous thought, nor is it associated with strokes - when other factors are controlled for.
 
The calcification however can impede AV nodal conduction and therefore lead to varying degrees of heart block.
 
Pathologically it is important to distinguish annular calcification, which is not on the leaflet, and is covered with intact endothelium, from leaflet calcification in stenotic valves secondary to rheumatic fever.
<br clear="right"/>


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:cardiology]]
[[Category:Valvular heart disease]]
[[Category:Cardiology]]
[[Category:Disease]]
[[Category:Cardiac surgery]]
[[Category:Surgery]]
[[Category:Overview complete]]


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Latest revision as of 16:19, 26 January 2020



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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

Overview

The chest X-ray in individuals with chronic mitral regurgitation (MR) is characterized by the presence of an enlargement of the left atrium and the left ventricle. In acute MR, pulmonary edema is present and the heart is not enlarged.

Chest X Ray

  • In acute MR, chest X-ray reveals pulmonary edema caused by pulmonary congestion secondary to the abrupt rise in pressure in the left atrium. There is no enlargement of the cardiac silhouette in acute MR.[1]
  • In chronic MR, the pulmonary vascular markings are typically normal since the pulmonary venous pressures are usually not significantly elevated. The left side of the heart might be enlarged. The left main bronchus can be pushed up by an enlarged left atrium.
  • Calcification of the mitral annulus is not infrequent, and is seen in up to 35% of elderly patients on echocardiography which is more sensitive than chest X-ray. It typically begins around the margins of the posterior leaflet forming a “C”, eventually the “C” closes forming an “O” with anterior leaflet involvement. [3])
    Calcification of the mitral annulus
    Calcification of the mitral annulus

References

  1. Mitral regurgitation https://radiopaedia.org/articles/mitral-valve-regurgitation (2016) Accessed on December 13, 2016

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