Beruflich Dokumente
Kultur Dokumente
2002
Recognizing
Congestive
Heart Failure
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Peribronchial cuffing
Wall is normally hairline thin
Pleural effusions
Normal
5-10 mm Hg
Cephalization
10-15 mm
Kerley B Lines
15-20
20-25
> 25
Kerley B Lines
Intersecting
network of lines
are Kerley A lines
in proper clinical
setting
Peribronchial Cuffing
Bronchial wall is usually not visible
Interstitial fluid accumulates around bronchi
Causes thickening of bronchial wall
When seen on end, looks like little
doughnuts
Meaningful when seen distal to hilar area
parenchyma
Normal fissure
is thickness of a
sharpened pencil line
Fluid may collect in any fissure
Major, minor, accessory fissures, azygous
fissure
Pleural Effusion
location
Laminar effusions collect beneath visceral
pleura (subpleural)
In loose connective tissue between lung
and pleura
Same location as pseudotumors
Normal
5-10 mm Hg
Cephalization
10-15 mm
Kerley B Lines
15-20
20-25
> 25
upper
Pulmonary alveolar
edema has a
butterfly or batwing configuration
Pulmonary Edema
Types
Cardiogenic
Neurogenic
Increased capillary permeability
E.g. Allergic reactions
L to R shunts
Usually from
Shortness of breath
Paroxysmal nocturnal dyspnea
Orthopnea
Cough
Important Points
The four reliable signs of CHF are:
Kerley B lines
Fluid in the fissures
Peribronchial cuffing
Pleural effusion
NOT cardiomegaly
NOT cephalization
Click to go forward
Click to go back
Yes
No
Go ahead
Yes
No
Go ahead
Yes
No
Go ahead
Yes
No
Go ahead
Correct
This is CHF
There are
Kerley A
and B lines
at the right
lung base
and a
small right
effusion
Go ahead
Correct
This is CHF
There is
diffuse
airspace
(alveolar)
disease which
has somewhat
of a bat-wing
appearance
Go ahead
Correct
There is No CHF
There are multiple
nodules in both lungs
from metastatic disease
Go ahead
Correct
This is CHF
There are Kerley B lines
visible at both lung bases
Go ahead
Wrong
Look Again
Remember to look
CHF
Kerley B lines
Fluid in the fissures
Peribronchial cuffing
Pleural effusion
Go Back
I know
CHF
when I
see it