CTICasesAsymmetric Pulmonary Edema from Mitral Valve Regurgitation
Imaging findings
Radiographs and CT scans demonstrate highly asymmetric pulmonary edema, characterized by prominent alveolar consolidation and interstitial edema localized preferentially to the right upper lobe. CT findings include asymmetric septal thickening, peribronchial fluid cuffing, subpleural edema along the major fissure, and an asymmetric right-sided pleural effusion.
Key takeaways
Severe mitral valve regurgitation, often caused by mitral valve prolapse or a flail chordae tendineae (such as a flail posterior leaflet P2 segment), can produce a regurgitant jet directed toward the orifice of the right superior pulmonary vein. This selective jet increases hydrostatic pressure in the right upper lobe, producing a characteristic asymmetric right upper lobe pulmonary edema that can easily mimic pneumonia or aspiration.
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