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Radiological appearance of mitral regurgitation

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Appearances vary with respect to whether the mitral regurgitation is a chronic feature (eg rheumatic heart disease) or whether it is of an acute onset (eg mitral regurgitation post myocardial infarct).

  • acute mitral regurgitation:
    • gross pulmonary oedema
    • no enlargement of left atrium or increased cardiothoracic ratio
  • chronic mitral regurgitation:
    • cardiomegaly:
      • dilated left ventricle (preloaded ventricle), atrial appendage and atrium (high left atrial pressure).
      • signs of pulmonary venous hypertension eg upper lobe vein diversion (pulmonary arterial resistance greater in lower lobes).
      • if there is no additional left ventricular disease then the heart size correlates with the degree of mitral regurgitation.

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