Pulmonary oedema

Case contributed by Dr Abeer Ahmed Alhelali

Presentation

Presented with shortness of breath

Patient Data

Age: 60 years
Gender: Male
Modality: X-ray

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.

No pneumothorax.

Findings are suggesting cardiogenic interstitial pulmonary oedema.

Case Discussion

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.

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Case Information

rID: 51448
Case created: 16th Feb 2017
Last edited: 17th Feb 2017
System: Chest
Inclusion in quiz mode: Included

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