Adult respiratory distress syndrome in a patient with uncomplicated acute myocardial infarction.
A 53-year-old woman was admitted with a diagnosis of acute extensive anterior myocardial infarction. Pulmonary capillary wedge pressure was 17 mmHg, and cardiac index 2.4 l/min.m2. The patient was successfully treated with diuretics and nitrates but on the fifth hospital day moist rales were noted over the entire lung field. A chest roentgenogram showed diffuse bilateral pulmonary infiltration with unchanged cardiac silhouette. Arterial oxygen partial pressure was reduced to 45 mmHg under 3 liters of nasal oxygen inhalation. Pulmonary capillary wedge pressure was 8 mmHg. Diffuse infiltration was not ameliorated by intravenous injection of diuretics. The diagnosis of adult respiratory distress syndrome was finally established by successful treatment with steroids.
Yoshida
N
N
Cardiology Division, Kamiokacho Hospital, Gifu, Japan.
Ejiri
M
M
Yasumoto
K
K
Fujita
M
M
Sasayama
S
S
D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000188:drug therapy; D010102:Oxygen Inhalation Therapy; D011669:Pulmonary Wedge Pressure; D013902:Radiography, Thoracic; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy