Patients with mitral stenosis exhibit a reversal of normal pulmonary blood flow distribution, with higher flow in the upper lung zones, which can be measured using radioactive gases.
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Reversal of pulmonary blood flow distribution may reflect elevated left atrial pressure in mitral stenosis; leaves open prospective validation for clinical use.
Using radioactive oxygen (O 15 ), carbon monoxide and carbon dioxide with external counting over the chest, it is possible to measure perfusion and diffusion per unit of lung volume. Patients with mitral stenosis, particularly those with high pulmonary artery pressures, may show a higher blood flow through the upper zone of the lung than the lower. This distribution of blood flow is the reverse of that found in normal subjects. The observed changes in blood flow are consistent with the radiological and pathological changes in the pulmonary vascular tree in mitral stenosis.
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Dollery et al. (1960) studied this question.
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