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March 1950


Author Affiliations


From the Chest Diseases Service of Dr. Harry B. Reibstein, Beth-El Hospital.

Arch Intern Med (Chic). 1950;85(3):483-489. doi:10.1001/archinte.1950.00230090120009

THE LUNG parenchyma in patients with compensated mitral stenosis has usually been reported as free of pathologic signs. Physicians have been taught to expect a normal lung picture in the early stages of this disease. With time, the progressive fibrosis of the valve and the chordae tendineae bring about cardiac inefficiency with diffuse engorgement of the pulmonary vessels, best seen at the hilus. This progressive loss of cardiac reserve finally manifests itself as outright decompensation, with pulmonary edema and pleural effusions. Except for the intercurrent complication of infarcts, this is the routine description of the pulmonary findings.1

However, in the more recent roentgenologic texts and in the literature, there have occasionally been described disseminated miliary nodules in the lungs of patients with long-standing mitral stenosis.2 This occurrence has been considered unusual; less than 25 cases were reported in the American literature during the ten years previous to this report.