The roentgen diagnosis of mitral stenosis and its differentiation from mitral insufficiency are more important than ever now that mitral commissurotomy is available.
The ideal patient for mitral commissurotomy is one who has pure mitral stenosis, or at least no predominating insufficiency, with no involvement of any of the other heart valves, and who has pulmonary congestion but no right heart failure. Auscultation may be misleading because there may be a loud systolic murmur when the mitral valve is predominantly stenotic; surgery will benefit the patient.
Roentgen examination is often of help. Radiographs furnish more exact information than fluoroscopy and provide a permanent record besides. We have found films in the anteroposterior and lateral positions most helpful, together with the right oblique. (The left oblique view is of little value for determining left ventricular enlargement.) Fluoroscopic examination is useful in detection of calcification of the valves. We have also been
KIRSH IE, KINNEY JF. The Roentgen Diagnosis of Mitral Stenosis. AMA Arch Surg. 1959;79(5):785-790. doi:10.1001/archsurg.1959.04320110087014