Pulmonary edema

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

A and E patient. Obese. Acutely short of breath. Apyrexic. Inspiratory crepitations in both lungs.

Patient Data

Age: 65 years
Gender: Female
x-ray

Bilateral perihilar airspace opacification with upper lobe venous distension.

Fluid in the horizontal fissure.

Despite the AP projection the heart is enlarged.

Case Discussion

Bilateral airspace opacification (due to alveolar edema) in both lungs centered on the perihilar regions.  Upper lobe venous distension.

The appearances are classical of acute pulmonary edema. 

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