CXR Case 110

An 86 year old lady is admitted breathless, hypoxaemic and hypotensive with a systolic of 95mmHg

CXR CASE 110 CXR LITFL

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.


CLINICAL CORRELATION

This lady has multiple features of pulmonary oedema, likely from congestive cardiac failure.


CLINICAL PEARLS

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 |

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