Pulmonary Edema

  • Etiology:
    — Cardiogenic – left heart failure / congestive heart failure, rheumatic heart disease causing mitral valve disease, aortic stenosis, arrthymias, myocardial disease – myocarditis / cardiomyopathy
    — Non cardiogenic – acute asthma, near drowning, acute glomerulonephritis, hemolytic uremic syndrome, adult respiratory distress syndrome
  • CXR: Perihilar infiltrates of butterfly wing distribution

Cases of Pulmonary Edema

CXR of cardiogenic pulmonary edema in asthma
CXR AP (left) shows cardiomegaly and bilateral perihilar interstitial infiltrates due to pulmonary vascular congestion. CXR AP (right) obtained after resolution of symptoms shows the heart and pulmonary vascularity to be normal in appearance while the airways are thickened and the lungs are hyperexpanded.
CXR of pulmonary edema due to mitral insufficiency in rheumatic heart disease
CXR AP shows cardiomegaly and bilateral perihilar interstitial infiltrates.
CXR of pulmonary edema in paroxysmal atrial tachycardia
CXR AP shows mild cardiomegaly and bilateral perihilar interstitial infiltrates due to pulmonary vascular congestion.
CXR of pulmonary edema in acute glomerulonephritis
CXR PA and lateral shows cardiomegaly and bilateral perihilar interstitial infiltrates along with blunting of the costophrenic angles due to small bilateral pleural effusions best seen on the lateral.
CXR of pulmonary edema in near drowning
CXR AP shows a normal sized heart and bilateral perihilar interstitial infiltrates. There is also a dense opacity in the right upper lobe.