The electrocardiogram (ECG) may demonstrate notched or diphasic P waves and right axis deviation. On the chest radiograph, straightening of the left heart border, indicating left atrial enlargement, is a typical early radiographic finding. Eventually, findings of pulmonary congestion are noted: redistribution of flow to the upper lung fields, Kerley B lines, and an increase in vascular markings. The diagnosis of mitral stenosis should be confirmed with echocardiography or consultation with a cardiologist. The urgency for an accurate diagnosis and appropriate referral depends on the severity of symptoms.