Acute pulmonary oedema

Case contributed by A.Prof Frank Gaillard

Presentation

Acute onset breathlessness.

Patient Data

Gender: Male
X-ray

Alveolar and interstitial oedema.

Annotated image

Annotated alveolar oedema (white arrows) and interstitial oedema (black arrowheads).

Case Discussion

This patient presented with acute onset of dyspnoea. The frontal chest radiograph is the key to diagnosis of acute pulmonary oedema.

It shows evidence of both interstitial and alveolar oedema. Alveolar oedema manifests as ill-defined nodular opacities tending to confluence (see image with arrows). Interstitial oedema can be seen as peripheral septal lines - Kerley B lines (arrowheads).

Peripheral septal lines are due to thickening of the interlobular septa. They are 1-3cm long and extend to the pleural surface. They may be due to pulmonary venous hypertension, as in this case. Other causes are: lymphangitis carcinomatosis; pneumoconioses; sarcoidosis; and pulmonary lymphoma.

Image contributed by: Dr Laughlin Dawes

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Case information

rID: 3011
Case created: 22nd May 2008
Last edited: 1st Sep 2015
System: Chest
Inclusion in quiz mode: Included

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