Presentation
Known cardiac patient presented with acute exacerbation of shortness of breath and cough.
Patient Data
There are bilateral, predominantly perihilar airspace opacities in a batwing appearance coalescing into consolidations with interposed interstitial components. There are also septal lines in the periphery of the right lung perpendicular to the pleura suggestive of Kerley B lines.
The cardiac outline is enlarged with cardiothoracic ratio of 57%.
There is blunting of the left costophrenic angle with loss of ipsilateral hemidiaphragm outline.
Left apical pleural capping with lung volume loss suggest anold process.
Case Discussion
Bat wing opacities are seen in many lung pathologies including cardiogenic pulmonary edema, pulmonary alveolar proteinosis and alveolar hemorrhage. It is characterized by bilateral perihilar lung shadowing classically seen on frontal chest x-ray.
In our a case, the presence of cardiomegaly, left side pleural effusion and Kerley B lines in a patient with known cardiac illness favors cardiogenic pulmonary edema over other differentials.
Presence of airspace opacities corresponds to grade III pulmonary edema.
Unable to process the form. Check for errors and try again.