Image Based Question-67285

A patient presented with worsening exercise tolerance ,chronic uncontrolled hypertension and rapid onset of shortness of breath.Chest X ray shows the following features.

What can be the most probable diagnosis?(right image shows a detailed view of right lower lobe)

A. Heart Failure.

B. Pneumonia.

C. Lung Collapse.

D. COPD.

Show Answer

Correct Answer » A Explanation

Ans:A. Heart Failure.

Chest X ray in the image shows:

Signs of heart failure

• Cardiomegaly CTR (Chest Thoracic ratio) (>50%)

• Upper zone vessel enlargement – a sign of pulmonary venous hypertension(marked by yellow lines)

• Septal (Kerley B) lines – a sign of interstitial oedema – see next picture

• Airspace shadowing – due to alveolar oedema – acutely in a peri-hilar (bat’s wing) distribution(marked by blue lines)

• Blunt costophrenic angles – due to pleural effusions

Probable Diagnosis is Left Ventricular Failure with Pulmonary Edema.