Chest X Ray of Heart Failure

Question 1

Describe stage 1 of the congestive heart failure

Answer 1

• Redistribution
• PCWP: 13-18mmHg
• redistribution pulmonary vessels
• Cardiomegaly

Question 2

Describe stage 2 of the congestive heart failure

Answer 2

•Interstitial oedema 
•PCWP 18-25mmHg 
•on CXR: 
- Kerley lines
- peribronchial cuffing 
- hazy contours of vessels
- thickened interlobal fissures

Question 3

Describe stage 3 of congestive heart failure

Answer 3

•Alveolar oedema 
•PCWP>25mmHg 
•CXR: 
- consolidation 
- air bronchogram 
- cottonwool appearance 
- pleural effusions

Question 4

How does heart failure occur?

Answer 4

• Problem with the heart puts strain on the heart
• blood starts to back up
• Blood backs up into the pulmonary veins
• Pressure rises more and more and fluid starts to leak out
• The fluid leak becomes more severe

Question 5

What does alveolar oedema look like on chest X-ray?

Answer 5

• Cotton wool appearance
• Consolidation
• Pleural effusions

Question 6

What are pleural effusions?

Answer 6

• fluid within the potential space between parietal and visceral fluid
• Divided into transudates and exudates (protein level of over 30g/l or LDH>200IU or pH<7.1 suggests exudate)