Presented with shortness of breath
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Suboptimal image as left CP angle is not included in the film.
Pacemaker device noted in the left hemithorax with one electrode in place.
Both lungs are congested with upper lobe pulmonary venous diversion, prominent interstitial lung markings and multiple kerley B lines.
Increased cardiothoracic ratio.
Right CP angle is clear.
Findings are suggesting cardiogenic interstitial pulmonary oedema.
Pulmonary edema is graded depending on chest x-ray and pulmonary capillary wedge pressure (PCWP) is as follows:
- grade 0: normal chest radiograph, PCWP 8-12 mmHg
- grade 1: upper lobe diversionon a chest radiograph, PCWP 13-18 mmHg
- grade 2: interstitial oedema on a chest radiograph, PCWP 19-25 mmHg
- grade 3: alveolar oedema on a chest radiograph, PCWP >25 mmHg
Our case is representing grade 2 pulmonary edema.