PrISM Cardiovascular

History:

41 year old male with dizziness on exertion and occasional chest pain. On physical exam he had a characteristic murmur of aortic stenosis.

These are two lateral radiographs on this same patient, one before and one after surgery. Try to find the abnormality before mousing over the labels. On Image B, there are also many surgical clips and sternal wire sutures from his surgery. The label on Image A shows faint calcifications in the region of the aortic valve, which are gone on Image B, after an aortic valve replacement.