ECG AND CHEST X RAY FEATURES OF MITRAL REGURGITATION

1. MITRAL REGURGITATION
- ECG, X-Ray

2. • CALIBRATION
• RATE,RHYTHM
• AXIS
• WAVE MORPHOLOGY
• INTERVALS
• ST SEGMENT
Approaching ECG

3. ECG changes in MR
• LA enlargement
• LEFT AXIS DEVIATION / NORMAL AXIS / RIGHT AXIS DEVIATION
• LVH / RVH
• ATRIAL FIBRILLATION

4. RATE,RHYTHM

5. AXIS

6. WAVES
INTERVALS

8. X-Ray in MR
• VIEW
• EXPIRATORY OR INSPIRATORY
• MARKER LOCATION
• EXPOSURE
• CENTRALISATION
• ABDOMINAL SITUS
• BRONCHIAL SITUS
• CARDIAC POSITION
• CARDIAC APEX
• CTR
• CHAMBER ENLARGEMENTS
• PULMONARY VASCULAR CHANGES

11. 210.10 imager mm
45.39 imager mm

17. PAH Grade X-Ray findings
Mild (25-40mmHg) MPA Dilatation
Moderate (41-55mmHg) MPA Dilatation
RD PA Dilatation (>
14mm)
Peripheral pruning
Severe (>55mmHg) MPA Dilatation (+/-
Calcification)
Hilar prominence
Severe pruning
Loss of retrosternal space
(RV Enlargement
PVH Grade X-Ray findings
Mild (13-18mm Hg) Staghorn Sign
Moderate (19-24mmHg) Kerley A,B,C lines
Peribronchial Cuffing
Severe (>25mm Hg) Cotton wool/Batwing
appearance.
Pleural edema.
Ossific nodule.
Left Ventricular Enlargement
• CTR
• LV Type Apex
MITRAL VALVE CALIFICATION
Left atrial enlargement
• Straightening of the left heart border
• Double atrial shadow
• Elevated left bronchus
• Widening of the carinal angle
• Walking man sign
• Posterior displacement of the esophagus

18. Thank You