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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pulmonary edema following i.v. contrast medium injection is a rare adverse reaction. We report on a 71-year-old woman who developed pulmonary edema following i.v. injection of iohexol during spiral CT of the thorax. She developed shortness of breath during the injection, and the first radiographic signs of pulmonary edema were visible on CT images 25 s after the onset of injection. On HRCT images 15 min later, marked edema was demonstrated in both lungs in a mosaic pattern of distribution. After appropriate therapy, the patient recovered without sequelae. A repeat CT 6 days later showed complete normalization.
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PMID:Pulmonary edema following intravenous injection of nonionic low-osmolar contrast medium--appearance on HRCT. A case report. 949 76

A 45-year-old female with atypical coactation of aorta and aortic regurgitation was treated with aortic valve replacement and extra-anastomic bypass between the ascending aorta and the left common iliac artery using a 12 mm woven dacron graft in 1978. She had complained of palpitation and shortness of breath six years after surgery, cinefluoroscopy demonstrated prosthetic valve dysfunction. Thrombolytic therapy was carried out to improve the valve function, but it did not result in improvement. Therefore, we decided to proceed with re-surgery. During a median sternotomy, massive bleeding from the substernal graft occurred. Therefore, we abandoned the re-surgery at that time. Then, her general condition was getting worse and she had occasional pulmonary edema fifteen years after the initial surgery. She finally underwent redo-aortic valve replacement with the aid of profound hypothermic circulatory arrest and selective cerebral perfusion. There was no cerebral complication after the re-surgery and she is now leading normal life. A median sternotomy under profound hypothermic circulatory arrest and selective cerebral perfusion was a very useful and safe procedure for patients who had risks of inadvertent injury to the aorta or the heart during the re-surgery.
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PMID:[A successfully procedure for the high risk redo-aortic valve replacement under profound hypothermic circulatory arrest and selective cerebral perfusion]. 966 62

The purpose of the study was to document the incidence and recurrence rate of pulmonary oedema induced by strenuous swimming (SIPO), and to study the changes in relevant physiological parameters. Thirty-five young men were repeatedly examined over a 2-month period after a swimming time trial in the open sea. A tentative diagnosis of SIPO was made when the swimmer reported shortness of breath accompanied by cough. Twenty-nine events of SIPO were diagnosed in 21 individuals (60% incidence). Oxygen saturation was significantly reduced in SIPO. Mean forced vital capacity (FVC) and FEV(1) were significantly lower in the severe SIPO group. Also, mean FVC and mid-expiratory flows (FEF(25-75%)) obtained 12 months earlier during screening for the programme were lower in individuals who later had SIPO. The ratios of post-swim FVC and FEV(1) values to the corresponding selection examination values were lower in the severe SIPO group. Thus volumes decreased in the SIPO group, besides being lower at the start. Shortness of breath and coughing following strenuous swimming were related to hypoxaemia and reduction in lung volumes, suggesting pulmonary oedema. SIPO was a common and often recurrent phenomenon. Lower initial lung volumes and flows might predict future susceptibility to SIPO.
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PMID:Pulmonary oedema induced by strenuous swimming: a field study. 1085 20

A patient with a history of tachycardiac atrial fibrillation and pulmonary embolism was admitted to the emergency unit with acute shortness of breath. The patient was on coumarin medication. Pulmonary embolism, heart failure, or pulmonary edema could be ruled out. Laryngoscopy revealed a huge hematoma of both valleculae extending to the lateral pharyngeal wall and the epiglottis. The epiglottic cartilage was displaced to the posterior pharyngeal wall. The INR was > 6. Prothrombin complex, vitamin K1, corticoids, and fresh frozen plasma were administered immediately. The patient was monitored--without tracheotomy--in the intensive care unit and received oxygen. In a patient with dyspnea, impaired ventilation has to be considered besides impaired perfusion or diffusion.
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PMID:[Dyspnea caused by spontaneous hematoma of the oropharynx and larynx during marcumar therapy]. 1132 Jun 26

Epidemic dropsy results from the consumption of edible oils adulterated with Argemone mexicana oil by unscrupulous traders. Twenty consecutive 'in-door' patients of dropsy were intensively studied during the recent Delhi epidemic. Samples of edible oil used by them, their urine and their serum samples tested positive for sanguinarine on thin layer chromatography. The illness starts as a gastro-enteric illness followed by oliguria and pedal oedema. The following are often observed: cutaneous erythema with blanching and tenderness on pressure; violacious pigmentation of the skin; shortness of breath with orthopnoea; right-sided heart failure with normal left ventricle (LV) functions; as well as severe anaemia and hypoalbuminaemia. Renal function tests showed: bland urinary sediments; decreased glomerular filtration rate (GFR); mild to moderate azotaemia; acute tubular necrosis; patchy pneumonitis; moderate hypoxia with respiratory alkalosis; and restrictive ventilatory defects on blood gas analysis; and spirometry suggestive of interstitial pulmonary oedema of non-cardiogenic origin. 99mTc colloid sulphur liver scans showed colloid shift. There was marked dilatation and proliferation of dermal capillaries in the absence of significant inflammation in the biopsy specimens. Toxic alkaloids of Argemone mexicana oil induce widespread capillary dilatation and permeability causing leakage of protein rich plasma into the interstitial tissues of various organs. A hypovolaemic state is thus induced producing renal hypoperfusion which may progress to acute tubular necrosis. Interstitial fluid in alveoli causes restrictive ventilatory dysfunction with hypertension and right-sided failure with well-preserved LV function. The hepatic venous congestion induces Kupffer's cell dysfunction, which results in colloid shift on a radionuclide liver scan.
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PMID:Epidemic dropsy: observations on pathophysiology and clinical features during the Delhi epidemic of 1998. 1193 Dec 4

A previously healthy 76-year-old woman presented with an acute onset of shortness of breath due to acute pulmonary oedema. A transthoracic echocardiogram showed a large mobile mass attached to the inter-atrial septum occupying the whole of the left atrium. She was totally asymptomatic prior to this presentation. She was transferred to a tertiary cardiothoracic unit and had it surgically removed. Histology confirmed a benign atrial myxoma. Her symptoms resolved spontaneously without the need for further medication. This highlights the importance of echocardiography for patients of any age who present to hospital with a first episode of pulmonary oedema. This report also emphasises the fact that all patients, including the elderly, should be immediately referred for surgery because of its good prognosis.
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PMID:Left atrial myxoma presenting with acute pulmonary oedema in an elderly woman. 1202 Jun 31

A 45-year-old patient developed shortness of breath, intensive cough, hemoptysis, chest pain and acute bilateral pulmonary infiltrates following the inhalation of crack-cocaine. The bronchoalveolar lavage and transbronchial biopsy revealed infiltrations of polymorphonuclear neutrophils and the formation of foreign body granulomas. The diagnosis of a crack-syndrome was made and the patient rapidly improved under temporary discontinuation of cocaine inhalation and symptomatic therapy. Crack-cocaine is the free-base of cocaine-hydrochloride and its chemical properties allows it to be inhaled tobacco-like. Therefore the lungs become the principal organs exposed and affected. In addition to our findings, diffuse damage of the alveolar wall and capillary injury due to vasoconstriction and toxic action were reported, in some cases rapidly progressing into pulmonary oedema and ARDS. As the consumption of crack cocaine in Germany has markedly increased over the past decade, a higher prevalence of the reported syndrome has to be assumed.
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PMID:[Crack-syndrome: the pulmonary complications of inhaled cocaine. A review a propos a case report]. 1244 9

An 81-year-old man with previous syncopal episodes, progressive shortness of breath, pulmonary edema, severe calcific aortic stenosis, and a history of heparin-induced thrombocytopenia required aortic valve replacement. Bivalirudin, a thrombin-specific anticoagulant, was used in place of heparin. The patient received a 50 mg bivalirudin bolus followed by an infusion between 1.5 mg x kg(-1) x h(-1) and 1.75 mg x kg(-1) x h(-1). Adequate anticoagulation was readily obtained resulting in an uneventful cardiopulmonary bypass. Activated clotting time (ACT) values steadily declined after discontinuation of the bivalirudin infusion. Bivalirudin is a practical alternative to heparin during cardiac surgical procedures.
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PMID:Favorable outcome with bivalirudin anticoagulation during cardiopulmonary bypass. 1253 26

Re-expansion pulmonary oedema is a well-recognized rare complication of the treatment of spontaneous pneumothorax. It has been associated with death in 20% of cases. A fit 20-year-old man who had returned from holiday 2 days previously presented with a large left-sided pneumothorax of 10 days' duration. He had exhibited symptoms of chest pain and shortness of breath during the return flight. He showed no signs of respiratory distress at presentation to the Accident and Emergency Department, but after treatment with a chest tube in the ensuing 90 min developed severe unilateral re-expansion pulmonary oedema and circulatory collapse. Factors in the aetiology of the condition and prevention are considered.
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PMID:Re-expansion pulmonary oedema and circulatory shock in a 20-year-old man. 1278 75

Increasing evidence suggests that neurohumoral manifestations of heart failure may lead to insulin resistance, predisposing patients with heart failure to the development of glucose intolerance or worsening of existing diabetes. Theoretically, insulin-sensitizing thiazolidinediones (TZDs) should be beneficial in this patient population. A 74-year-old man with well-compensated systolic dysfunction and longstanding type 2 diabetes mellitus treated with glyburide began therapy with rosiglitazone 4 mg/day, which was increased to 8 mg/day after 1 month. Two weeks later he was seen with a 5-kg weight gain, shortness of breath, bibasilar rales, +S3 gallop, and increased jugular venous distention. Twelve days later symptoms worsened, with pulmonary edema on chest radiograph, continued weight gain, and +4 pitting edema resistant to oral diuretics. The patient was admitted to the hospital for exacerbation of heart failure. Five days after discharge he was readmitted for similar symptoms, including an 11.8-kg weight gain. He reported adherence to drug therapy and diet. Rosiglitazone was immediately discontinued and 11 days later the man's weight stabilized to 79 kg and remained between 79 and 80 kg 2 and 3 months after discharge. This case demonstrates that TZDs may precipitate weight gain and pulmonary and peripheral edema in patients with stable heart failure. Earlier reports documented similar symptoms in patients without a history of heart failure. Although current recommendations state that TZDs should not be administered to patients with New York Heart Association class III or IV disease, practitioners should be aware that these adverse effects also may occur in patients with milder forms heart failure as well as those without heart failure.
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PMID:Possible heart failure exacerbation associated with rosiglitazone: case report and literature review. 1288 8


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