Chronic Kerley B lines in congestive heart failure
Known CHF with multiple exacerbations. Worsening dyspnea.
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- Enlarged heart and pulmonary vasculature.
- Prominent thickening of the interstitial septae
- Characteristic, unusually thick Kerley B lines best observed in the typical peripheral right basal lung zone (see magnified key image).
After multiple episodes of pulmonary interstitial edema due to CHF the septal lines of the lung can undergo fibrous transformation, which results in the Kerley B-lines becoming permanent. Afterwards therefore these chronic septal lines are no longer predictive of the clinical severity of the disease.