A. Chest X-Ray
A simple chest x-ray is the most important confirmatory test for the diagnosis of heart failure and reveals the following patterns.
• Interstitial pulmonary edema (signs of accumulation
of excessive blood and fluid components of the blood
in the spongework of the lung), pulmonary clouding,
perihilar haze, and Kerley B or A lines caused by edema
and thickening of interlobular septa
• Frank pulmonary edema (fluid within the alveoli and air sacs), alveolar pulmonary edema which causes a butterfly pattern that is occasionally unilateral
• Pleural effusions, the right usually greater than on the left
• Constriction of blood vessels in the lower lobe of the lung with dilatation of vessels in the upper lobes of the lung, a manifestation of pulmonary venous hyperten¬sion that is an early sign of left ventricular failure
B. B-Type Natriuretic Peptide
B-type natriuretic peptide is released from the cardiac ventricles in response to the increased wall tension that occurs in heart failure. Used in conjunction with the history, physical findings on examination, and a chest x-ray, the rapid measurement of B-type natriuretic peptide is useful in establishing or excluding the diagnosis of heart failure in patients with acute shortness of breath (see the chapter B-Type Natriuretic Peptide).

Страницы: 1 | 2