Cardiogenic pulmonary edema

Case contributed by Rania Adel Anan
Diagnosis almost certain


Dyspnea after coronary catheterization.

Patient Data

Age: 75 years
Gender: Male

Small bilateral patchy areas of ground glass opacities are seen in both lungs with a central peribronchovascular distribution,  associated with smooth subpleural and interlobular septal thickening (which indicates interstitial edema) and bilateral small pleural effusion.

A hyperdense stent is seen within the left anterior descending artery (LAD).

Reactive mediastinal lymphadenopathy is also seen.



Follow-up after 2 days revealed larger areas of bilateral airspace opacification with a central peribronchovascular distribution (giving batwing appearance),  associated with smooth interlobular septal thickening (giving crazy paving pattern).

No change regarding the previously noted bilateral mild pleural effusion and reactive mediastinal lymphadenopathy. 

Case Discussion

The patient presented with acute chest pain and was diagnosed clinically with the acute coronary syndrome. He underwent an urgent coronary catheterization & a stent was inserted into the LAD.

One day later the patient complained of dyspnea which worsened two days later.

CT findings were typical of cardiogenic pulmonary edema.

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