Imaging Case of the Week 340 Answer

The supine AP resus chest x-ray shows extensive bilateral alveolar opacities, which is indicative of pulmonary oedema. There is an endotracheal tube in place and there are external artifacts (i.e. ECG leads).

Non-cardiogenic pulmonary oedema in this case is likely due to negative pressure generated during recurrent seizure activity & aspiration.

A useful mnemonic to remember causes of non-cardiogenic pulmonary oedema:

NOT CARDIAC:

  • Near drowning.
  • Oxygen therapy.
  • Transfusion or trauma.
  • Central nervous disorders.
  • ARDS, aspiration.
  • Renal disorder or resuscitaion.
  • Drugs.
  • Inhaled toxins.
  • Allergic alveolitis.
  • Contrast reaction.

Reference: https://www.med-ed.virginia.edu/courses/rad/chest/f15pulCardiac.html