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Related Experiment Videos

The 'wet Westermark' sign.

Stuart J Hutchison1

  • 1Division of Cardiology, St Michael's Hospital, University of Toronto, Toronto, Canada. stuart.hutchison@utoronto.ca

The Canadian Journal of Cardiology
|May 7, 2002
PubMed
Summary
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Mild heart failure can accentuate Westermark's sign on chest X-rays, aiding in the diagnosis of pulmonary embolism after heart surgery. This finding highlights how heart failure can serve as a radiographic contrast marker.

Area of Science:

  • Cardiology
  • Radiology
  • Pulmonary Medicine

Background:

  • Postoperative complications after aortocoronary bypass grafting (CABG) can include respiratory distress.
  • Pulmonary embolism (PE) is a critical concern in the postoperative cardiac surgery population.
  • Radiographic findings are crucial for diagnosing cardiopulmonary complications.

Observation:

  • A 67-year-old female presented with dyspnea and exertional intolerance post-CABG.
  • Chest radiography revealed regional oligemia, prompting suspicion of PE.
  • Mild heart failure due to volume overload was also noted.

Findings:

  • Perfusion scanning confirmed defects in the oligemic areas, supporting the diagnosis of PE.
  • Interstitial markings, enhanced by heart failure, acted as an indirect radiographic contrast.

Related Experiment Videos

  • This enhancement highlighted areas of regional underperfusion, consistent with Westermark's sign.

    • Implications:

    • Mild heart failure can paradoxically improve the visibility of Westermark's sign.
    • This observation offers a novel diagnostic clue for PE in postoperative cardiac patients.
    • Integrating findings of heart failure and oligemia can refine the interpretation of chest radiographs for PE detection.