What are the important findings and diagnostic possibility?
Cardiac silhouette is mildly enlarged with predominant rightward shift of right margin, indicating right atrial enlargement. Left border is straightened out, with mild prominence of main pulmonary artery segment and region of the left atrial appendage. Right pulmonary artery is also visible above the right atrial contour on the right side. Upper lobe vessels are prominent. Upper lobe vessels more than 3 mm in size are suggestive of pulmonary venous hypertension with cephalization or redistribution of pulmonary blood flow. Normally the lower lobe vessels are more prominent due to the effect of gravity. Over all the x-ray picture is suggestive of mitral stenosis with pulmonary venous and arterial hypertension. Redistribution of pulmonary blood flow seen as prominent upper lobe vessels are known by other names like antler sign and inverted mustache sign.