Picture Diagnosis - PAC

Q: 54 years old male is admitted to ICU with congestive heart failure. Pulmonary Artery Catheter (PAC) (swan-Ganz catheter) is floated? CXR 6 hours apart are shown below. Your diagnosis?

 

Answer: Pulmonary infarct 

A Swan-Ganz catheter has been inserted too far into the right pulmonary artery (A). Several hours later, an infiltrate is present in this region (B) as a result of lung infarction.

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Reference:

Reinke RT, Higgins CB. Pulmonary infarction complicating the use of Swan-Ganz catheters. Br J Radiol. 1975 Nov;48(575):885-8. doi: 10.1259/0007-1285-48-575-885. PMID: 1218298.