What are the Stage 1 signs (redistribution) of HF on CXR?
- Redistribution of the pulmonary vessels
What are the Stage 2 signs (interstitial oedema) of HF on CXR?
- Kerley lines
- Peribronchial cuffing
- Hazy contours of vessels
- Thickened interlobular fissures
What are the Stage 3 signs (alveolar oedema) of HF on CXR?
- Air bronchogram
- Cottonwool appearance
- Pleural effusions
What pulmonary capillary wedge pressures (PCWP) are associated with which stages of HF?
- Stage 1 – PCWP 13-18mmHg
- Stage 2 – PCWP 18-25mmHg
- Stage 3 – PCWP > 25mmHg
What is defined as cardiomegaly?
- Assessed using cardiothoracic ratio (CTR)
- Should be <0.5
What is upper lobe blood diversion?
- Upper lobe pulmonary venous diversion (cephalisation) is where the pulmonary veins are dilated
- It reflects elevation of left atrial pressure and can occur with pulmonary oedema.
- It produces Stag-antler's sign on frontal chest x-ray.
- The normal left atrial pressure is 5-10 mmHg. An elevation of left atrial pressure to 10-15 mmHg will result in cephalisation.
What are Kerley B lines?
- Septal lines (fluid leakage into interlobular septa)
What is interstitial oedema?
- Fluid accumulating in loss connective tissue beneath visceral pleura
What is alveolar oedema?
- Fluid from interstitium into alveolar spaces resulting in airspace opacity
- Bat's wing distribution
What are pleural effusions?
- Fluid within potential space between parietal and visceral pleura
What is the ABCDE of CXR signs for HF?
- Alveolar oedema (bat's wings)
- Kerley B lines (interstitial oedema)
- Dilated prominent upper lobe vessels
- Effusion (pleural)