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Radiology General 0889fe5b

All are seen in congestive cardiac failure except:

A
Kerly B lines
B
Prominent lower lobe vessel
C
Pleural Effusions
D
Cardiomegaly
High-Yield Explanation
B i.e. Prominent lower lobe vessels In CCF/ Left hea failure there is cephalization of pulmonary vascularity (i.e. dilatation of upper lobe & constriction of lower zone vessels)Q, Kerley A lines (interlobular septal thickening)Q, Kerley (septal) B lines, perihilar haze and pseudoeffusionQ. Radiological features of left ventricle failure / congestive cardiac failure (produced due to pulmonary venous hypeension). Stage I Equalization (at pulmonary capillary wedge pressure 13-15 mm Hg) f/b cephalization of pulmonary vascularity (at 16-18 mmHg PCWP). It is characterized by: - Constriction & blurring of lower zone vesselsQ - Effacement of hilar angle Dilatation & prominence of upper lobe vesselsQ. Exceptions to this pattern of redistribution are basal emphysema & pulmonary parenchymal diseases of upper lobe. Stage 2 Interstial pulmonary edema (at PCWP-19124 mm Hg) occurs d/ t presence of fluid within peribroncho-vascular interstial tissue. It is seen as: - Peribronchial thickening /cuffing & indistinct vessel margins - Kerley A lines is 3-4 cm long lines of interlobular septal thickening radiating from hila to mid & upper long zones.. - Kerley (septal) B lines i.e. sho horizontal reticulations within lateral subpleural lung bases. - Perihilar hazeQ d/t hilar interstitial edema - Pseudoeffitsion d/t thickened pleural fissures and back ground haze (ground glass appearance)Q. Stage 3 Alveolar edema (at PCWP >25 mm Hg) occurs when the interstitial fluid accumulates at rates faster than it can be removed by the lymphatics. It is seen as - Bat's wing appearance d/t bilateral perihilar & basilar air space opacification - B/L small pleural effusion usually occurs when systemic venous pressure is also elevated as in right hea failure.

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