Cardiac Radiography > Pathology > Pathologic Conditions > Lesions Presenting with Pulmonary Venous Hypertension

Lesions Presenting with Pulmonary Venous Hypertension

These lesions tend to fall into one of four categories: left ventricular systolic dysfunction (first figure below), obstruction to left ventricular inflow, severe mitral regurgitation, and acute systemic or pulmonary volume overload. Common causes of LV failure include ischemic heart disease, myocardiopathy, and aortic valve disease. The prototypical cause of obstruction to LV inflow is mitral valve stenosis (second figure below), but more common is poor LV compliance (stiff ventricle) resulting from LV hypertrophy, hypertrophic cardiomyopathy, or chronic ischemia. Severe mitral regurgitation, especially when acute, will dramatically increase left atrial and pulmonary venous pressure. Common causes of volume overload include acute renal failure and iatrogenic overhydration. As with the normal vascularity-normal heart size category, it is important to look for specific signs of cardiac disease.

Left ventricular failure from myocardial ischemia causing interstitial and airspace edema 

Rheumatic mitral valve stenosis. There is enlargement of the left atrium (arrows, left) and left atrial appendage (arrows, right). The latter is relatively specific for rheumatic heart disease and is rarely seen in non-rheumatic mitral disease. 


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