This is a basic article for medical students and other non-radiologists
Pulmonary edema refers to the abnormal accumulation of fluid in the extravascular compartments of the lung. This initially results in interstitial edema and perihilar airspace opacification.
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Reference article
This is a summary article; read more in our article on pulmonary edema.
Summary
-
epidemiology
- a wide group of affected individuals
-
presentation
- chest pain
- shortness of breath
- diaphoresis
- desaturation
-
pathophysiology
- abnormal accumulation of fluid in the lungs, leading to impaired gas exchange and possibly respiratory failure
- causes
- cardiogenic
- non-cardiogenic
- numerous causes, see here
-
investigation
- chest X-ray
- first-line investigation
- search for potential causes
- blood tests
- electrolytes to search for causes
- renal function
- chest X-ray
-
treatment
- diuretics
- oxygen
- nitrates and morphine (for acute pulmonary edema)
- respiratory support
Radiographic features
Chest X-ray
- cephalisation of upper lobe vessels
- interstitial opacities
- peribronchovascular cuffing
- septal lines (a.k.a. Kerley B lines)
- airspace opacification
- filling of the alveoli with fluid
- when severe and acute, has a perihilar or 'batwing' distribution
- air bronchograms: air-filled bronchi running through fluid-filled alveoli
- pleural effusion
CT chest
- same as CXR
- may see the cause
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