Radiographic examination demonstrated enlarged, poorly defined vessels. Effusion was noted in the major and minor interlobar fissures, seen on the lateral radiograph. Kerley A-lines extended out from the hila and Kerley B-lines were noted at the right lung base, consistent with interstitial edema. There was poor visualization of the left heart border and left diaphragm due to pleural effusion. The heart was significantly enlarged. Poor visualization of the aortic knob was noted and cephalization of vessels was seen, consistent with venous hypertension. Incidentally, degenerative changes were noted in the spine (See Figures Below).
PAand Lateral Chest radiograph. Note the cephalization of vessels. Cardiomegaly and pleural effusion are apparent.
Question: These radiographic features are consistent with what diagnosis and what should you do next?
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