Congestive cardiac failure (CCF) is a form of cardiac failure which is primarily manifested by the heart's inability to pump the volume of blood. It can affect the left (common) or right cardiac chambers or both.
It may be precipitated by intrinsic cardiac or extrinsic factors (which include coronary artery disease, hypertension, valvular heart disease). It may also be acute (acute decompensated cardiac failure) or chronic (chronic congestive cardiac failure). Up to 40-50% of patients have diastolic heart failure with preserved left ventricular function 6.
The accuracy of interpreting chest radiographs regarding congestive cardiac failure was only around 70% according to one study 2.
With left-sided congestive cardiac failure, the features are that of pulmonary oedema which includes:
- central pulmonary venous congestion
- cephalisation of pulmonary veins
- pulmonary interstitial oedema
- pulmonary alveolar oedema
- cardiomegaly (may or may not be present)
- 1. Cardinale L, Priola AM, Moretti F et-al. Effectiveness of chest radiography, lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure. World J Radiol. 2014;6 (6): 230-7. doi:10.4329/wjr.v6.i6.230 - Free text at pubmed - Pubmed citation
- 2. Mueller-Lenke N, Rudez J, Staub D et-al. Use of chest radiography in the emergency diagnosis of acute congestive heart failure. Heart. 2006;92 (5): 695-6. doi:10.1136/hrt.2005.074583 - Free text at pubmed - Pubmed citation
- 3. Gluecker T, Capasso P, Schnyder P et-al. Clinical and radiologic features of pulmonary edema. Radiographics. 1999;19 (6): 1507-31. doi:10.1148/radiographics.19.6.g99no211507 - Pubmed citation
- 4. Spinar J, Vítovec J, Blaha M et-al. Radiologic changes in chronic heart failure. Cor Vasa. 1993;34 (1): 88-99. Pubmed citation
- 5. Chakko S, Woska D, Martinez H et-al. Clinical, radiographic, and hemodynamic correlations in chronic congestive heart failure: conflicting results may lead to inappropriate care. Am. J. Med. 1991;90 (3): 353-9. Pubmed citation
- 6. King M, Kingery J, Casey B. Diagnosis and evaluation of heart failure. Am Fam Physician. 2013;85 (12): 1161-8. Pubmed citation