CTICasesMitral Valve Disease and Pulmonary Venous Hypertension
Imaging findings
Chest radiograph shows cardiomegaly with a massive left atrium, and redistribution of pulmonary blood flow to the upper lobes (cephalization). Large, parallel artery-vein pairs are visible, with the dilated superior pulmonary vein lying lateral to the artery. CT confirms severe chronic mitral valve disease.
Key takeaways
Chronic left atrial/pulmonary venous hypertension leads to remodeling of the lower lung pulmonary vasculature (intimal hyperplasia). This causes permanent redistribution of blood flow to the upper lobes, which persists even after valve replacement.
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