During diagnostic chest percussion on a patient with CHF or pulmonary edema, what sound is typically expected?

In patients with congestive heart failure (CHF) or pulmonary edema, the accumulation of fluid in the lungs results in a change in the normal air-filled lung sound during percussion. A dull or flat percussion note is typically expected due to the presence of fluid that dampens the sounds.

A normal resonant percussion note indicates healthy, air-filled lungs. In contrast, a flat or dull sound reflects the transition from air-filled lung tissue to areas where fluid has accumulated, such as in the case of pulmonary edema. Therefore, when assessing for conditions like CHF, healthcare practitioners anticipate a dull sound when percussing over the lung fields affected by fluid retention. This is a key diagnostic finding that helps to differentiate between normal lung conditions and those with pathological changes like pulmonary edema.

The hyper-resonant percussion note is typically associated with conditions such as pneumothorax or emphysema, while a "bright" percussion note is not a recognized description in clinical practice. Thus, the expectation of a dull or flat percussion note aligns perfectly with the pathophysiological changes seen in CHF or pulmonary edema.