Localized Pulmonary Edema in Patient with Severe Mitral Regurgitation.
10.4046/trd.2005.59.4.432
- Author:
Young Gul YOON
1
;
Do Seok BANG
;
Bum Chul PARK
;
Sung Hoon LEE
;
Jae Su KIM
;
Yol PARK
;
Young Chul HONG
;
Kyoung Tae KO
;
Sang Min PARK
;
Sang Hoon HAN
;
Sang Hoon PARK
;
Jun Cheol LIM
;
Dong Jib NA
Author Information
1. Department of Internal Medicine, Sun Hospital, Dae Jeon, Korea. djna@sunhospital.com
- Publication Type:Original Article
- Keywords:
Pulmonary edema;
Mitral regurgitation
- MeSH:
Aged, 80 and over;
Anti-Bacterial Agents;
Auscultation;
C-Reactive Protein;
Cardiomegaly;
Cough;
Dyspnea;
Echocardiography, Doppler, Color;
Edema;
Electrocardiography;
Female;
Fever;
Furosemide;
Heart;
Hematologic Tests;
Humans;
Hypertension;
Leukocytosis;
Lower Extremity;
Lung;
Mitral Valve Insufficiency*;
Pleural Effusion;
Pneumonia;
Pulmonary Edema*;
Radiography, Thoracic;
Respiration;
Respiratory Sounds;
Sputum;
Systolic Murmurs;
Tachycardia, Sinus
- From:Tuberculosis and Respiratory Diseases
2005;59(4):432-435
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
An 82-year-old female non-smoker with a history of hypertension presented with increasing dyspnea, cough and some purulent sputum without fever. Upon admission, the patient was in a distressed condition. Auscultation revealed diminished breath sounds with no rales over the right lung. An examination of the heart revealed a regular rhythm and a systolic murmur radiating from the apex of the heart. There was no pitting edema in the lower extremities. The blood tests showed mild leukocytosis and an increased C-reactive protein level. The O2 saturation was 98 % whilst breathing room air. The electrocardiogram demonstrated sinus tachycardia. The chest radiograph showed a moderate cardiomegaly, right lobe infiltrates, and blunting of the both costophrenic sulcus suggesting a small pleural effusion. Three days after admission, the symptoms became slightly aggravated despite being treated with empirical antibiotics for presumed community-acquired pneumonia. Transthoracic color Doppler echocardiography indicated an ejection fraction of 48 %, mild left ventricular enlargement, and moderate left atrial enlargement resulting in severe mitral regurgitation. The clinical symptoms and right pulmonary edema resolved quickly with intravenous furosemide treatment.
