Prominent upper lobe vessels in X-ray chest in mitral stenosis indicate:
a) Antler sign
b) Pulmonary venous hypertension
d) All of the above
Correct answer: d) All of the above
X-RAY FEATURES OF MITRAL STENOSIS
Mitral stenosis is associated with the development of pulmonary hypertension
When the severity of pulmonary venous hypertension increases, there is a redistribution of pulmonary blood flow towards the upper lobes.
This is known as cephalization.
It is also known as ‘Antler sign’ and ‘Upturned moustache sign’.
A shadow of the left atrium is seen overlying the right atrium – shadow in shadow sign / double atrial shadow.
Left atrial dilatation leads to straightening of the left heart border and elevation of the left main bronchus.
The pulmonary arteries are prominent due to pulmonary arterial hypertension
Kerley B lines may be seen near the costophrenic angles due to thickened interlobular septa
The right heart border can be shifted to the right indicating right atrial dilatation secondary to pulmonary hypertension and right ventricular hypertrophy.