Presentation
Chronic, worsening shortness of breath.
Patient Data
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Chest xrays demonstrates very marked hyperinflation of both lungs. Over 11 posterior ribs are seen, the diaphragms are flattened and there is enlargement of the retrosternal airspace. Pulmonary vasculature not terribly distorted, although there is some prominence of the pulmonary arteries.
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Lateral chest x-ray from a different (normal but well inflated) patient.
The thickness of the space between the ascending aorta and the sternum is normally no more than 2.5cm.
The normal dome of each hemidiaphragm should rise at least 1.5cm above a line connecting the costophrenic angle posteriorly and sternophrenic angle anteriorly
Case Discussion
This case demonstrates unequivocal and marked hyperinflation secondary to emphysema.
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