Upper lobe venous diversion

Case contributed by Usman Bashir
Diagnosis almost certain

Patient Data

Gender: Female

Plain radiograph obtained in upright position shows cardiomegaly (defined as cardiothoracic ratio >0.5 on upright films in full inspiration). Of note, upper lobar veins are at least as prominent as lower lobe vessels - in the appropriate clinical context, this serves as a sign of early pulmonary edema.

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