CXR Interstitial Edema

CXR LAE CHF with INTERSTITIAL EDEMA- MYOCARDITIS – POLY SUBSTANCE ABUSE VF ARREST NEG CORONARIES
55-year-old male with no prior history became unresponsive during sexual intercourse. Required CPR and defibrillation, and subsequently required epinephrine drip
Echo showed EF 50-55%, and normal cardiac chambers.
CXR showed CHF and LAE
Cardiac Cath showed normal coronaries, PCW 25 mm Hg
MRI showed mildly dilated LV and normal sized left atrium, right atrium and right ventricle. There was LGE in the mid myocardium in the apical anterior wall . Ejection fraction was 47% and myocardial mass was 61g/sqm. End diastolic volume was 160 ccs. Associated findings included bilateral pleural effusions. Finding were most consistent with a myocarditis, or sarcoidosis. Also included in the differential diagnosis was methamphetamine analogue use.
CXR following placement of a pacemaker/defibrillator showed improved CHF
Ashley Davidoff MD

 

See Kerley Lines

CHF with ALVEOLAR EDEMA and KERLEY A LINES
62-year-old male in the ICU with a tracheostomy with acute respiratory distress.
CXR shows acute alveolar edema with an air bronchogram in the right upper lobe (red arrow, a), and red circle, b)with Kerley A lines extending from the periphery to the hila and mediastinum (white arrows)
Ashley Davidoff MD
Peribronchial Cuffing
CHF with ALVEOLAR EDEMA and PERIBRONCHIAL CUFFING
62-year-old male in the ICU with a tracheostomy and in acute respiratory distress.
CXR shows acute alveolar edema with an air bronchogram in the right upper lobe (red arrow, a), and red circle, b) with peribronchial cuffing around bilateral mid lung bronchi (teal arrows)
Ashley Davidoff MD

 

Presented with Interstitial edema

After Pacemaker improved

Other Causes of Peribronchial Cuffing