Mediastinal lymphadenopathy (MLA) is not commonly recognized as associated with congestive heart failure (CHF). However, recent case series have reported a 35% to 81% incidence of MLA in different patient populations with CHF. [1][2][3][4] However, the true incidence remains unknown as these reports analyzed different heart failure populations.The lymphatic circulation is primarily responsible for regulating pulmonary fl uid homeostasis. The lymphatic system is highly recruitable and, with time to adapt, can increase clearance of pulmonary edema fl uid by . 10-fold. This system enables low-pressure drainage of excessive fl uid from the interstitium through lymph nodes (LNs) and into collecting ducts. Lymphatic Abbreviations: CHF 5 congestive heart failure; CO 5 cardiac output; EBUS 5 endobronchial ultrasound; EF 5 ejection fraction; EUS 5 endoscopic ultrasound; HT 5 heart transplantation; LN 5 lymph node; MLA 5 mediastinal lymphadenopathy; MPAP 5 mean pulmonary artery pressure; MR 5 mitral regurgitation; MUGA 5 multigated acquisition scan; PCWP 5 pulmonary capillary wedge pressure; RAP 5 right atrial pressure; RVG 5 radionuclide ventriculography; TR 5 tricuspid regurgitation
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