Radiological signs in mitral stenosis

Radiological signs seen in mitral stenosis are:

• Backward displacement of esophagus by enlarged left atrium (in lateral view X-ray)
• Enlarged left atrium in AP view X-ray (Blood pools in the left atrium as it is unable to pass into the left ventricle. This results in progressive dilatation.)
• Straightening of left heart border
• Double shadow due to enlarged left atrium
• Splaying of carina (The left main bronchus is lifted up by the enlarged left atrium)
• Prominent upper zone pulmonary veins (Inverted moustache sign /  Antler’s horn sign / Cephalisation pulmonary of blood flow)
• Enlarged pulmonary trunk (This occurs following the development of pulmonary hypertension)
• Kerley B lines (indicating fluid collection in the interlobular septa)
• Calcification of mitral valve