Q. What is Pulmonary Venous Congestion ?

In pulmonary venous hypertension, the earliest change is an increase in calibre of the upper lobe vessels. If the upper lobe veins measure more than 3 mm in the first interspace, they reflect an increase in pulmonary venous pressure.

Grading of Pulmonary Venous Hypertension

Grade 1: Diameter of upper zone vessels greater than or equal to lower zone; right hilar angle obliterated.

Grade 2: Interstitial pulmonary edema or pleural effusion; right hilar angle straightened; Kerley B lines and later Kerley A lines.

Grade 3: Alveolar edema; Right hilar angle convex.