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Congestive heart failure (CHF) patients have typical radiological features that assist in diagnosis. This is a case that demonstrates an atypical radiologic presentation for CHF which showed diffuse pulmonary nodules on CT. Diffuse nodules can be present in several disease processes and clinical correlation is a necessity for diagnosis. It is important for radiologists and clinicians to be aware of uncommon radiological features of CHF to avoid unnecessary procedures or treatments.