Images: On the initial radiograph, vascular clarity is diminished and there is generalized interstitial prominence which appears to particularly involve the right upper lobe. The heart is enlarged and there are small bilateral pleural effusions. On the follow up radiograph, the edema pattern has improved.
MRI SSFP cine images demonstrate a flow jet across the mitral valve consistent with insufficiency.
Unilateral/asymmetric pulmonary edema cases represents approximately 2% of cardiogenic pulmonary edema. It typically involves the right upper lobe and is strongly associated with severe mitral regurgitation. This may be because the regurgitation jet is directed towards the right superior pulmonary vein which would preferentially increase the hydrostatic pressure in the right upper lobe. Other causes include re-expansion edema, pulmonary vein occlusion, and positioning related. When associated with mitral regurgitation, it is usually a result of a flail posterior leaflet, which can be caused by rupture of the chordae tendineae or papillary muscle.
(Click for a larger image.)
| Radiology |
Medicine/Pulmonary |
| VCU Resident |
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| Others |
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| Mohammed Althobaiti | Saudi Arabia |
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| Krishna Prasad Bellam Premnath | United Kingdom |
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| Carlo Florio | Italy |
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| Abdul Jabbar | Pakistan |
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| JAYANTH KESHAVAMURTHY | United States of America |
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| Amarah Kiani | Pakistan |
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| Robert Palmer | United States of America |
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| Hiroaki Takahashi | Japan |
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| Herlina Uinarni | Indonesia |
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