Emphysema and congestive cardiac failure

Case contributed by RMH Core Conditions
Diagnosis certain

Presentation

Dyspnea, dizziness and ST elevation on ECG

Patient Data

Age: 83
Gender: Female

Chest

x-ray

Cardiac size is within normal limits for mobile projection. The lungs appear emphysematous and there is mild fluid overload with upper lobe diversion but no frank pulmonary edema. No pneumothorax.

The patient proceeded to the catheter lab where LV-gram showed severe LV failure. The patient then developed decreased oxygen saturations and bibasal creps ?APO. Repeat x-ray four hours after initial. 

Chest

x-ray

Interstitial and alveolar edema have developed since the previous examination.

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