Pulmonary Oedema Case 1

• These views both show numerous B-lines.
• The changes are diffuse, symmetrical and bilateral.
• Pneumothorax, COPD and focal infection are far less likely now.
• Pulmonary oedema is the most common cause of this appearance.
• Pneumonitis, lymphangitis carcinomatosis and pulmonary fibrosis can also cause a similar appearance although these can usually be differentiated from the history and associated clinical features.
• Sonographic features including distribution of involvement, presence of pleural effusions and echocardiography are also invaluable in further assessment.

Bibasal small to moderate anechoic pleural effusions are present. The likelihood of pulmonary oedema of cardiac origin is more likely still.

This apical 5 chamber view shows very poor left ventricular function, particularly of the apex and interventricular septum again supporting the diagnosis of pulmonary oedema of cardiac origin.

Further views excluded severe valvular dysfunction.