A general radiologist looks at congestive heart failure

Congestive heart failure may be difficult to detect. Determination of cardiac size is untrustworthy. Changes in the hili (vessels, bronchi) are reliable. Pulmonary edema may be atypical. Vascular redistribution must be interpreted accurately. Congestive changes with chronic obstructive lung disease may be difficult or impossible to detect. Pleural fluid may present atypically. Changes in pleural surfaces other than in bases produce "new" signs.