Cough and pink frothy sputum

Some differential diagnoses and typical outline evidence

Acute pulmonary oedema	Suggested by: onset over minutes or hours of shortness of breath, orthopnoea, displaced apex, loud 3rd heart sound, fine crackles at lung base.
	Confirmed by: CXR appearance (see 640) poor LV function on echocardiogram.
	Management: OHCM pp136–8, 786.
Mitral stenosis	Suggested by: months or years of orthopnoea, mitral facies, tapping, displaced apex, loud 1st heart sound, diastolic murmur, fine crackles at lung base. Enlarged left atrial shadow (behind heart) and splayed carina on CXR.
	Confirmed by: large left atrium and mitral stenosis on echocardiogram.
	Management: OHCM p146.