Question

All of the following are found in left ventricular failure (LVF) EXCEPT:

• A. Lung oligemia
• B. Kerley B lines
• C. Rales
• D. Pedal edema

Hint:

A failing left heart floods the lungs; which option means the lungs have too little blood instead?

Answer 1

The Correct Option is A

Step 1: What LVF does to the lungs. Left ventricular failure backs blood up into the pulmonary circulation, raising pulmonary venous pressure. This causes pulmonary congestion, not reduced blood flow.
Step 2: Match the real findings. Chest X-ray shows cardiomegaly, prominent upper lobe veins, Kerley B lines (interstitial edema), bat-wing alveolar shadowing, and pleural effusion. On examination there are rales (crepitations) from alveolar fluid, and later pedal edema as failure progresses.
Step 3: Spot the exception. Lung oligemia means decreased pulmonary blood flow, which is the opposite of the plethora and congestion of LVF. Oligemia is seen in conditions like pulmonary embolism, not LVF.
Step 4: Conclusion. So lung oligemia is the feature NOT found in LVF. Ref: Harrison's Principles of Internal Medicine, 20e.