Left Atrial Enlargement:
The patient below is a 26 year old female with rheumatic heart disease complicated by mitral stenosis and mitral regurge. The chest radiograph demonstrates marked left atrial (LA) enlargement. The left atrial shadow projects beyond the right heart border on the PA exam and there is splaying of the carina by the enlarged LA. On the lateral view, density is seen over the spine at the level of the left atrium, but some of this density is due to markedly dilated left pulmonary vein. The pulmonary arteries are normal. (Click here to view lateral exam) The patient also had a chest CT which can be used for correlation with the CXR (Click here to view the Chest CT on this patient).
