Pulmonary Oedema
February 15th, 2021
Overview
Signs of Pulmonary Oedema on Chest X-Ray
- Bat-wing appearance - opacities extending laterally in a fan shape from each hilum
- Kerley A lines - 5-10cm lines extending from the hila to the periphery (fluid in the deep septa)
- Kerley B lines - 1.5-2cm lines seen in the periphery of the lower lung extending into the pleura (interlobular septal thickening)
- Air bronchograms - tubular outlines of the smaller airways
- Upper lobe diversion (cephalisation) - enlarged upper lobe vessels and smaller lower lobe vessels
- Associated cardiomegaly (cardiogenic)
Causes of Pulmonary Oedema
Cardiogenic
- Heart failure
- Fluid overload
- Renal failure
- Transfusion-associated circulatory overload (TACO)
Non-Cardiogenic
- Acute respiratory distress syndrome
- Pulmonary embolism
- Re-expansion pulmonary oedema (e.g. with drainage of a pleural effusion or pneumothorax)
- Neurogenic pulmonary oedema
- Transfusion-related acute lung injury (TRALI)
- High altitude pulmonary oedema (HAPE)
Examples
- Perihilar opacification and increased interstitial markings in keeping with early pulmonary oedema
![Perihilar opacification and increased interstitial markings in keeping with early pulmonary oedema]()
- Upper lobe venous diversion
![Upper lobe venous diversion]()
- Batwing opacities consistent with acute pulmonary oedema
![Batwing opacities consistent with acute pulmonary oedema]()
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