Differential diagnosis of pediatric pulmonary edema

  • Cardiogenic
    — Left heart failure / congestive heart failure
    Rheumatic heart disease causing mitral valve disease
    — Aortic stenosis
    — Myocardial disease – myocarditis / cardiomyopathy
  • Non cardiogenic
    — Acute asthma
    Near drowning
    — Acute glomerulonephritis
    — Hemolytic uremic syndrome
    — Adult respiratory distress syndrome

Approach to the differential diagnosis of pulmonary edema:

  • The key finding in pulmonary edema is bilateral perihilar interstial infiltrates. There may be other signs of pulmonary edema present such as Kerley’s B lines or pleural effusions
  • One way to distinguish cardiogenic from non cardiogenic etiologies is to look for cardiomegaly; if cardiomegaly is present the etiology of the pulmonary edema is most likely cardiogenic