What indicates cardiac decompensation on a radiograph?

Kerley B-lines are indicative of cardiac decompensation, primarily reflecting pulmonary congestion or interstitial edema associated with heart failure. On a radiograph, these lines appear as short, thin, horizontal lines at the lung periphery, typically in the lower zones, and represent fluid accumulation in the interstitial spaces of the lungs. This occurs when the left heart cannot efficiently pump blood, leading to increased pressure in the pulmonary circulation and consequent fluid leakage into the interstitium.

Recognizing Kerley B-lines helps healthcare professionals assess the severity of cardiac failure and guide management strategies. The presence of these lines points to pulmonary congestion rather than other phenomena that may be observed on a chest X-ray.