Lung Changes in Left Heart Failure

The lung changes in left heart failure are grouped into four main categories or stages: (1) pulmonary congestion, (2) interstitial edema, (3) alveolar edema, and (4) miscellaneous findings. Some patients, particularly those with mitral stenosis, develop these changes gradually, passing successively through the stages of pulmonary congestion → interstitial edema → alveolar edema. Other patients, particularly those with hypertension or myocardial infarction, often develop rapid left heart failure and tend to show alveolar edema. The roentgen diagnosis of incipient or early heart failure is important since pulmonary auscultatory findings may be minimal or absent.