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The Roentgen Diagnosis of Mitral Stenosis

The Roentgen Diagnosis of Mitral Stenosis Abstract The roentgen diagnosis of mitral stenosis and its differentiation from mitral insufficiency are more important than ever now that mitral commissurotomy is available. The ideal patient for mitral commissurotomy is one who has pure mitral stenosis, or at least no predominating insufficiency, with no involvement of any of the other heart valves, and who has pulmonary congestion but no right heart failure. Auscultation may be misleading because there may be a loud systolic murmur when the mitral valve is predominantly stenotic; surgery will benefit the patient. Roentgen examination is often of help. Radiographs furnish more exact information than fluoroscopy and provide a permanent record besides. We have found films in the anteroposterior and lateral positions most helpful, together with the right oblique. (The left oblique view is of little value for determining left ventricular enlargement.) Fluoroscopic examination is useful in detection of calcification of the valves. We have also been References 1. Dealy, J. B., Jr.: Mitral Valve Disease: A Radiologic Approach to a Physiological Diagnosis , New England J. Med. 254:825-829 ( (May 3) ) 1956.Crossref 2. Fleischner, F. G., and Reiner, L.: Linear X-Ray Shadows in Acquired Pulmonary Hemosiderosis and Congestion , New England J. Med. 250:900 ( (May 27) ) 1954.Crossref 3. Grishman, A., and Kane, I. J.: Disseminated Calcified and Bony Nodules in the Lungs Associated with Mitral Disease , Am. J. Roentgenol. 53:575-581 ( (June) ) 1945. 4. Jacobson, H. G.; Poppel, M. H.; Hanenson, I. B., and Dewing, S. B.: Left Auricular Enlargement , Am. Heart J. 43:423-437 ( (March) ) 1952.Crossref 5. Pendergrass, E. P.; Lame, E. L., and Ostrum, H. W.: Hemosiderosis of Lungs Due to Mitral Disease , Am. J. Roentgenol. 61:443-456 ( (April) ) 1949. 6. Wells, H. G., and Dunlap, C. E.: Disseminated Ossification of the Lungs , Arch. Path. 35:420-426 ( (March) ) 1943. 7. Zinsser, H. F.: Selection of Patients for Mitral Commissurotomy , Am. J. Med. 17:804-810 ( (Dec.) ) 1954.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

The Roentgen Diagnosis of Mitral Stenosis

A.M.A. Archives Surgery , Volume 79 (5) – Nov 1, 1959

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Publisher
American Medical Association
Copyright
Copyright © 1959 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1959.04320110087014
Publisher site
See Article on Publisher Site

Abstract

Abstract The roentgen diagnosis of mitral stenosis and its differentiation from mitral insufficiency are more important than ever now that mitral commissurotomy is available. The ideal patient for mitral commissurotomy is one who has pure mitral stenosis, or at least no predominating insufficiency, with no involvement of any of the other heart valves, and who has pulmonary congestion but no right heart failure. Auscultation may be misleading because there may be a loud systolic murmur when the mitral valve is predominantly stenotic; surgery will benefit the patient. Roentgen examination is often of help. Radiographs furnish more exact information than fluoroscopy and provide a permanent record besides. We have found films in the anteroposterior and lateral positions most helpful, together with the right oblique. (The left oblique view is of little value for determining left ventricular enlargement.) Fluoroscopic examination is useful in detection of calcification of the valves. We have also been References 1. Dealy, J. B., Jr.: Mitral Valve Disease: A Radiologic Approach to a Physiological Diagnosis , New England J. Med. 254:825-829 ( (May 3) ) 1956.Crossref 2. Fleischner, F. G., and Reiner, L.: Linear X-Ray Shadows in Acquired Pulmonary Hemosiderosis and Congestion , New England J. Med. 250:900 ( (May 27) ) 1954.Crossref 3. Grishman, A., and Kane, I. J.: Disseminated Calcified and Bony Nodules in the Lungs Associated with Mitral Disease , Am. J. Roentgenol. 53:575-581 ( (June) ) 1945. 4. Jacobson, H. G.; Poppel, M. H.; Hanenson, I. B., and Dewing, S. B.: Left Auricular Enlargement , Am. Heart J. 43:423-437 ( (March) ) 1952.Crossref 5. Pendergrass, E. P.; Lame, E. L., and Ostrum, H. W.: Hemosiderosis of Lungs Due to Mitral Disease , Am. J. Roentgenol. 61:443-456 ( (April) ) 1949. 6. Wells, H. G., and Dunlap, C. E.: Disseminated Ossification of the Lungs , Arch. Path. 35:420-426 ( (March) ) 1943. 7. Zinsser, H. F.: Selection of Patients for Mitral Commissurotomy , Am. J. Med. 17:804-810 ( (Dec.) ) 1954.Crossref

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Nov 1, 1959

References