Differential Diagnosis
- Single most likely diagnosis
- Chronic Heart Failure (CHF): The presence of cardiomegaly, central pulmonary venous engorgement, and minimal volume bibasilar pleural effusions are highly suggestive of CHF. The patient's obesity and age also increase the likelihood of this diagnosis.
- Other Likely diagnoses
- Chronic Obstructive Pulmonary Disease (COPD): Hyperexpansion of the lungs and flattening of the hemidiaphragms are characteristic of COPD. The patient's age and obesity are also risk factors for COPD.
- Pulmonary Edema: The presence of central pulmonary venous engorgement and bibasilar pleural effusions could also be indicative of pulmonary edema, which may be related to CHF or other causes.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Pulmonary Embolism (PE): Although less likely, PE can present with similar radiographic findings, including pulmonary venous engorgement and pleural effusions. Given the potential for high mortality, PE should be considered and ruled out.
- Pneumonia: The presence of basilar predominant linear and reticular opacities could also be indicative of pneumonia, which would require prompt antibiotic treatment.
- Rare diagnoses
- Lymphangitic Carcinomatosis: This rare condition can present with similar radiographic findings, including pulmonary venous engorgement and pleural effusions. However, it is less likely given the patient's presentation and lack of other suggestive findings.
- Interstitial Lung Disease (ILD): The presence of basilar predominant linear and reticular opacities could also be indicative of ILD, although this would be less likely given the patient's age and lack of other suggestive findings.