Pulmonary congestion in chronic heart disease. Radiologic, clinical and hemodynamic relationships

Pulmonary congestion in chronic heart disease was evaluated by lung auscultation and roentgen examination of the chest and compared with pressure recording of the pulmonary circulation in 49 cases. Whereas auscultation appeared not to be correlated to the pressures, the radiologic findings proved to be a reliable measure of increased pressures. The radiologic assessment was based on isolated flow shift to the upper lobes of the lungs, indicating slight pulmonary venous hypertension, and flow shift in association with blurring of the lower lobe vessels, indicating pulmonary interstitial oedema. In distinction to the results from acute cardiac failure interlobular septa were often demonstrated in association with pulmonary interstitial oedema, and pulmonary alveolar oedema rarely demonstrated in spite of marked pulmonary venous hypertension.