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Radiological appearance of mitral stenosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Possible features include:

  • cardiothoracic ratio:
    • the heart size is normal (small left ventricle)

  • in the presence of pulmonary hypertension there will be right ventricular hypertrophy and tricuspid regurgitation, a dilated right atrium and pulmonary artery

  • dilated left atrium - the carina will be splayed

  • pulmonary vessels:
    • increased flow through upper lobes as pulmonary vascular changes begin in the lower lobes
    • hydrostatic pressure increases pulmonary venous pressure in lower lobes
    • the pulmonary artery and branches dilate with pulmonary hypertension

  • Kerley's lines:
    • are caused by interlobular oedema and dilated lymphatics
    • they appear as horizontal line shadows at the costophrenic angles
    • Kerley's lines indicates a high left atrial, and pulmonary venous, pressure

  • in long standing and severe mitral stenosis there may be calcification of the mitral valve

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