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Pulmonary congestion occurs when the amount of extravascular fluid in the lungs increases. Pulmonary congestion develops in 2 stages. Interstitial edema occurs with collection of fluid in the interalveolar septa and Kerley B lines appear. Kerley B lines are seen as 3-6 mm long horizontal lines in the lateral basal segments of the lung, near the chest wall (on the frontal film). They develop when the pressure in the interstitium exceeds about 18-20 mm Hg. At this stage, the patient usually becomes