Fact-sheet: Congestive heart failure
Updated on 09/17/2021 at 12:16 PM
View all RADEOS cases associated with this fact-sheet
Definition
Definition:
Fluid accumulation in the extravascular pulmonary space.
Begins with interstitial involvement (subclinical) then extends to the alveolar space.
Mechanism: -
Increased capillary hydrostatic pressure of cardiac origin
Radiography
- Cardiogenic edema. Three stages of increasing severity. Vascular stage: - Equalization of pulmonary vascularity (equalization of vessel caliber between the bases and the apices) - then vascular redistribution toward the apices (reversal of the base/apex vascular ratio). Interstitial stage: - Kerley lines - Peribronchial cuffing with ring sign - Fissural thickening - Pleural effusion. Alveolar stage: - Always preceded by the interstitial stage - Alveolar syndrome: bilateral and symmetric opacities, predominating in the perihilar regions and sparing the apices and bases
CT
- Thickening of the septal lines: linear opacities perpendicular to the pleura, several centimeters long, outlining the pulmonary lobules
- Thickening of the subpleural interstitium, fissural thickening
- Enlarged arteries and thickened bronchial walls
- Perihilar ground-glass opacity, followed by consolidation upon worsening
- Pleural effusion
- Hypodense mediastinal lymphadenopathy