Presentation
Cough for 6 weeks, transient improvement with furosemide.
Patient Data
The heart is markedly enlarged with elevation of the trachea. The heart occupies more than half the thoracic width on the dorsoventral projection. There is a diffuse, patchy interstitial to alveolar pulmonary pattern that is most pronounced in the right caudal lung lobe. The musculoskeletal structures appear normal. The peritoneal detail appears decreased.
Case Discussion
Cardiomegaly and heart failure causing pulmonary edema. This degree of heart enlargement without prominent left atrial enlargement suggests cardiomyopathy. Cardiomyopathy was diagnosed on echocardiography.
The relatively normal pulmonary vasculature and dependent distribution of the pulmonary edema with a nodular appearance are typical of chronic heart failure and diuretic therapy.
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