What observation might a therapist note on chest assessment for a patient with CHF or pulmonary edema?

In patients with congestive heart failure (CHF) or pulmonary edema, the clinical findings during a chest assessment can indicate the presence of fluid in the alveolar spaces, leading to increased transmission of sound. Increased tactile and vocal fremitus occurs because the lung tissue becomes denser due to the fluid accumulation, which allows for better vibration conduction of sounds from the bronchi to the chest wall.

When a therapist assesses tactile fremitus, they place their hands on the patient's chest and ask the patient to repeat certain words or sounds. If the sounds are more pronounced (increased fremitus), this suggests that the lung tissue is consolidated or contains an increased amount of fluid, as seen in conditions like pulmonary edema. This contrasts with scenarios such as pleural effusion or pneumothorax, where you would typically observe decreased fremitus due to the presence of fluid or air that acts as an insulator.

Thus, the observation of increased tactile and vocal fremitus aligns with the expected findings for a patient experiencing CHF or pulmonary edema, emphasizing the pathology's impact on lung function and sound transmission.