Professional and Linguistic Assessments Board (PLAB) Practice Exam

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Which heart condition is indicated by a straight left heart border on an X-ray?

Mitral Regurgitation
Mitral Stenosis
Aortic Stenosis
Left Ventricular Hypertrophy

The correct answer is: Mitral Stenosis

A straight left heart border on an X-ray typically indicates a condition associated with left atrial enlargement. In this context, mitral stenosis is the correct condition linked with this finding. Mitral stenosis leads to increased pressure in the left atrium due to the narrowing of the mitral valve, which in turn causes the left atrium to dilate. This dilation can give the heart silhouette a more squared-off appearance on X-rays, making the left heart border appear straight rather than rounded. While other conditions can cause changes in the heart silhouette, they may not specifically present with a straight left heart border in the same manner. For example, mitral regurgitation typically results in left atrial and ventricular enlargement but is less likely to produce the distinct straightening of the left heart border seen in mitral stenosis. Aortic stenosis affects the left ventricle and may not lead to left atrial enlargement that would visibly change the heart border on an X-ray. Left ventricular hypertrophy also alters the heart shape but mainly impacts the outline of the left ventricle rather than the left heart border directly.