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This is the aortic knuckle. It can occur in severe pulmonary hypertension, there can be right atrial enlargement, as the severe hypertrophy of the right ventricle causes elevation of right ventricular end diastolic pressure, and later on right atrial enlargement. It is not visible here. And you are seeing some end on views probably.
So that is why we see straightening of left border, typically heard of in mitral stenosis with left atrial enlargement and mild pulmonary hypertension. When there is gross pulmonary hypertension, instead of these being straight over here, it will form a bulge over here.
Transcript of the video: Eisenmenger syndrome is an important complication of large left to right shunts which develop later due to development of pulmonary vascular obstructive disease and severe pulmonary hypertension. Some even say that those with Eisenmenger in ASD are really those who are destined for primary pulmonary hypertension.
You can see the ventricular septal defect and aortic over ride. One, the flow may be increased in the long run, leading to pulmonary hypertension and pulmonary vascular disease. And, usually this done, Blalock-Taussig shunt, classic shunt, opposite to the side of the aortic arch. Right to left shunt is also visible.
Guidelines on hypertension (high blood pressure) generally recommend measurement of blood pressure in both arms in the initial visit. Another important serious disease which has to be thought of in a person with pain in the chest or upper back is aortic dissection. Aortic dissection is tear in the inner lining of the aorta.
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