Perfusion Changes on Lung Scans in Patients with Congestive Heart Failure

Analysis of the lung scans of 69 patients with congestive heart failure revealed that the most common pattern was multiple small, ill-defined nonsegmental perfusion defects, corresponding to indistinct opacities on chest films. When scans showed larger perfusion defects, radiographs showed alveolar densities. Other lung scan signs were redistribution of pulmonary perfusion in the upper and lower lobes, perfusion changes due to pleural fluid, and cardiac enlargement. Distinctive differences between patterns of congestive heart failure and those of chronic lung disease and pulmonary thromboembolism are discussed.