Chest X-ray Level 2 Tutorial: Congestive Heart Failure
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Tutorial: Congestive Heart Failure
Learn an approach to CHF findings on chest x-ray
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Tutorial: Congestive Heart Failure Vascular Redistribution
Lessons
42
Times Practiced
1284
Cases Completed
1h 24m
Total Time spent
1m 24s
Average Time
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1 Pathophysiology Pathophysiology
2 Enlarged Heart Enlarged Heart
3 Vessel to Bronchus ratio Vessel to Bronchus ratio
Current lesson 4 Vascular Redistribution Vascular Redistribution
5 Peribronchial Cuffing Peribronchial Cuffing
6 Kerley lines Kerley lines
7 Alveolar Edema Alveolar Edema
8 Fluid in fissures Fluid in fissures
9 Fluid in Pleural Space Fluid in Pleural Space
10 CHF Summary CHF Summary
Vascular Redistribution
When the intravascular pressure increases, vessels in the top half of the lung which are normally underfilled (due to the effects of gravity) become more filled. This gives an appearance of vascular markings in the top half of the lung being as prominent and a similar size (diameter) as vascular markings in the lower half of the lung.

When this happens, it is called vascular redistribution. In this x-ray, there is no vascular redistribution. Vascular markings in the top half of the lung can be seen, but they are normal (smaller and less prominent than vessels in the lower half of the lungs):


When vascular redistribution occurs, it is usually in the presence of other findings of congestive heart failure, such as interstitial edema or alveolar edema, making the lung appear whiter. In fact, the extra fluid in the vessels, interstitial spaces, and alveolar spaces will all contribute to making the lungs appear more white in congestive heart failure.

In the following example, vascular redistribution is present: