radiological appearance of pulmonary venous hypertension
Last reviewed 01/2018
Chest radiology changes vary with respect to the developing pulmonary hypertension.
Early changes include Kerley B lines.
Later changes include:
- fluffy appearance of horizontal veins in the lower zones. These veins are dilated due to increased venous pressure and may be mistaken for Kerley B lines.
- upper lobe diversion - both a visual illusion and a real phenomenon:
- the increased venous pressure causes transudate to drain into the interstitium and so reduces the contrast between fluid filled blood vessels and the background
- the flow to the veins in the upper lobes is increased as a result of the more voluminous interstitium putting pressure on veins in the lower zones
- peribronchial cuffing
- pleural effusion - occurs as a result of transudative fluid within the pleural cavity
radiograph showing cardiomegaly and pulmonary oedema