A Medically Treated Case of Renal Artery Stenosis Presented with `Flash Pulmonary Edema'.
- Author:
Seon Sook HAN
1
;
Dae Hee CHOI
;
Sung Won LEE
;
Hui Young LEE
;
Woo Jin KIM
;
Sang Hyun LEE
;
Hae Hyuk JUNG
Author Information
1. Department of Internal Medicine, College of Medicine, Kangwon National University, Chuncheon, Korea. haehyuk@kangwon.ac.kr
- Publication Type:Case Report
- Keywords:
Flash pulmonary edema;
Renal artery stenosis;
Renin-angiotensin system
- MeSH:
Angiography;
Angiotensins;
Cardiovascular Diseases;
Constriction, Pathologic;
Dialysis;
Dyspnea;
Humans;
Kidney;
Pulmonary Edema;
Renal Artery Obstruction*;
Renal Artery*;
Renal Insufficiency;
Renin-Angiotensin System;
Respiration, Artificial;
Spironolactone
- From:Korean Journal of Nephrology
2003;22(4):474-478
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Renal artery stenosis is a rare cause of acute pulmonary edema. So-called flash pulmonary edema is associated with bilateral renal artery stenosis or stenosis in a single functioning kidney. Most patients have co-morbid cardiovascular disease and a renovascular etiology is overlooked. Flash pulmonary edema has been recognized as an absolute indication for vascular intervention. However, our case could be treated with medical treatment directing a complete inhibition of renin-angiotensin system. A 81- year old man was admitted with acute shortness of breath. During that admission, despite the dialysis therapy for renal insufficiency, he had four severe episodes of acute pulmonary edema requiring mechanical ventilation. CT angiography showed bilateral renal artery stenosis. After administration of ACE inhibitor, angiotensin receptor blocker, and spironolactone, there was no further attack of pulmonary edema.
