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Dx Wisely
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Chest X-ray
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Chest X-ray
Level 2
Tutorial: Congestive Heart Failure
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Tutorial: Congestive Heart Failure
Learn an approach to CHF findings on chest x-ray
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Tutorial: Congestive Heart Failure
Fluid in fissures
Lessons
42
Times Practiced
1284
Cases Completed
1h 24m
Total Time spent
1m 24s
Average Time
Progress
Accuracy
Efficiency
Accuracy
Efficiency
1
Pathophysiology
Pathophysiology
2
Enlarged Heart
Enlarged Heart
3
Vessel to Bronchus ratio
Vessel to Bronchus ratio
4
Vascular Redistribution
Vascular Redistribution
5
Peribronchial Cuffing
Peribronchial Cuffing
6
Kerley lines
Kerley lines
7
Alveolar Edema
Alveolar Edema
8
Fluid in fissures
Fluid in fissures
9
Fluid in Pleural Space
Fluid in Pleural Space
10
CHF Summary
CHF Summary
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Fluid in fissures
Along the continuum of pathophysiology in congestive heart failure, the increased fluid pressure and volume will start in the LA then go into the pulmonary vessels, pulmonary interstitial spaces, the alveolar spaces, and then the fluid will actually exit the lung and enter the
pleural space
.
When this happens, a
pleural effusion
is produced. Pleural effusions can be seen on chest x-ray.
When fluid exists between the lobes of the lung, the
oblique fissures
(seen on lateral chest x-ray) and
horizontal fissure
(see on frontal chest x-ray) become thicker and more white and are easier to see.
Here are some examples of "
fluid in the fissure
":
The x-ray above shows a very thick horizontal fissure. Often, the fissure is bright white but no so thick. In fact, in this chest x-ray, you can see evidence of the fluid between the lung and the ribs as well:
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