Pulmonary arteriogram in pulmonary hypertension secondary to mitral stenosis

This pulmonary arteriogram performed in a patient with mitral stenosis demonstrates marking shunting of blood to the pulmonary vasculature of the upper lobes, away from the left and right lower lobes, as a result of constriction of the lower lobe vessels secondary to pulmonary venous hypertension. Also seen is dilation of the left atrium (arrow).