Case 2: lung abnormalities

(SOB due to calcific pericarditis and CHF)

There is engorgement of the upper lobe pulmonary vessels.  In the upright position, which we assume this patient is in, most of the blood flow in the pulmonary vessels goes to the lower lobes.  The upper lobe vessels should be very thin, thread-like opacities.  In this case, they are enlarged, indicating backup of blood in the pulmonary circuit, which may be contributing to the patient’s symptoms. This is called 'pulmonary vascular redistribution' or PVR for short