**Question:** All are radiological features of Mitral stenosis except

A. Pulmonary congestion
B. Pulmonary artery enlargement
C. Pericardial effusion
D. Right ventricular hypertrophy

**Core Concept:**
Mitral stenosis (MS) is a valvular heart disease characterized by the narrowing of the mitral valve orifice, leading to an increase in pulmonary vascular resistance and decreased cardiac output. Radiological features help in diagnosing and assessing the severity of the condition.

**Why the Correct Answer is Right:**
The correct answer, D. Right ventricular hypertrophy, is not a radiological feature of mitral stenosis because right ventricular hypertrophy is more commonly associated with pulmonary hypertension, a condition caused by increased pulmonary vascular resistance, not mitral stenosis itself. While MS can lead to pulmonary hypertension, right ventricular hypertrophy is a direct response to the increased afterload from pulmonary hypertension, not an MS-specific radiological sign.

**Why Each Wrong Option is Incorrect:**
A. Pulmonary congestion: This refers to fluid accumulation in the lungs, a condition known as pulmonary oedema. Although mitral stenosis can lead to pulmonary congestion, it is not a specific radiological feature of MS.

B. Pulmonary artery enlargement: This is a radiological finding that can be seen in pulmonary hypertension, which is a complication of mitral stenosis. However, pulmonary artery enlargement is not specific to mitral stenosis and can also occur in conditions like pulmonary hypertension or pulmonary artery banding.

C. Pericardial effusion: This refers to fluid accumulation around the heart, the pericardium. While mitral stenosis can cause pericardial effusion in advanced cases, it is not a specific radiological feature of mitral stenosis. Pericardial effusion can be seen in various cardiac conditions, including congestive heart failure, pericarditis, or tamponade.

**Core Concept:**
The radiological features of mitral stenosis include:

1. Pulmonary venous hypertension: Mitral stenosis causes increased resistance in the pulmonary veins, leading to dilation of the pulmonary veins and pulmonary arteries.
2. Cardiomegaly: Mitral stenosis can cause left ventricular hypertrophy, leading to an increased heart size.
3. Pulmonary artery enlargement: Mitral stenosis can lead to pulmonary hypertension, causing pulmonary artery dilation.

**Why Each Wrong Option is Incorrect:**
A. Pulmonary venous hypertension: This is a plausible feature of mitral stenosis but is not specific to the disease. It can be seen in other conditions like pulmonary embolism, chronic obstructive pulmonary disease, or left atrial thrombus.

B. Cardiomegaly: Mitral stenosis can lead to left ventricular hypertrophy, causing an increased heart size, which is a correct feature but not specific to mitral stenosis. Cardiomegaly can be seen in various cardiac conditions.

C. Pulmonary artery enlargement: Mitral stenosis can cause pulmonary hypertension, leading to pulmonary artery dilation. This is a correct