Pulmonary edema

Case contributed by Farris Asim Latief
Diagnosis almost certain


Reduced oxygen saturations, bilateral crepitations and reduced air entry on auscultation bilaterally. Three week history of worsening shortness of breath on exertion and bilateral pedal edema.

Patient Data

Age: 90 years
Gender: Female

There is perihilar air space opacification seen bilaterally with a small left pleural effusion. Appearances are suggestive of pulmonary edema.

Case Discussion

This patient presented with reduced oxygen saturations to the emergency department after a 3 week history of progressive dyspnea and was diagnosed with acute pulmonary edema secondary to heart failure, which was confirmed via echocardiogram. They were successfully treated with IV furosemide. 

Some classic features of pulmonary edema are demonstrated on this chest x-ray: pleural effusion and perihilar opacification. Other common features include upper lobe diversion and cardiomegaly (heart size was unable to be accurately assessed on these films).  

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