Localized Pulmonary Edema in Patient with Severe Mitral Regurgitation.

Yoon, Young Gul; Bang, Do Seok; Park, Bum Chul; Lee, Sung Hoon; Kim, Jae Su; Park, Yol; Hong, Young Chul; Ko, Kyoung Tae; Park, Sang Min; Han, Sang Hoon; Park, Sang Hoon; Lim, Jun Cheol; Na, Dong Jib

doi:2005.59.4.432

Tuberc Respir Dis > Volume 59(4); 2005 > Article

Original Article

Tuberculosis and Respiratory Diseases 2005;59(4):432-435.
DOI: https://doi.org/10.4046/trd.2005.59.4.432 Published online October 1, 2005.

Localized Pulmonary Edema in Patient with Severe Mitral Regurgitation.

Young Gul Yoon, 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

Department of Internal Medicine, Sun Hospital, Dae Jeon, Korea. djna@sunhospital.com

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.

Key Words: Pulmonary edema, Mitral regurgitation