CXR in patients with HD significant MS
- Quadruple contour: bouton Ao, AP, AAG, VG
- LA enlargement on the lateral and L anterior oblique views (although the cardiac silhouette may be N in the frontal projection)
o Angle carène > 90 degré
o Double contour F > 7 cm ou H > 7.5 cm
o Déplacement postérieur de l’oesophage (AP-oesophage > 4 cm)
- Enlargement of the PA (commonly seen in MS causing pHTN)
- Enlargement of the RV (commonly seen in MS causing pHTN)
- Enlargement of the RA (commonly seen in MS causing pHTN)
- Calcification of the MV (occasionally evident on CXR)
- Interstitial edema – Kerley B (an indication of severe obstruction, + in 70% of pts w/ PCWP > 20)
- Kerley A lines (straight, dense lines up to 4 cm in length, running toward the hilum) – with severe long-standing MS
- Pulmonary hemosiderosis and parenchymal ossification – with severe long-standing MS