CXR Case 110
An 86 year old lady is admitted breathless, hypoxaemic and hypotensive with a systolic of 95mmHg
Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
Even allowing for an AP film there is likely cardiomegaly.
There is upper lobe diversion, fluid in both pleural spaces and the horizontal fissure and Kerley B lines.
The arch of the aorta is calcified and may be aneursymal.
The left diaphragm is obscured suggesting lower lobe collapse or pleural fluid.
This lady has multiple features of pulmonary oedema, likely from congestive cardiac failure
A careful history for pain related to aortic dissection should be taken, and further imaging with contrast CT is indicated as well as BP from each arm.
TOP 150 CXR SERIES
Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar | ICIS Course ANZ