Pulmonary edema induced by fluid administration in acquired immune deficiency syndrome patients with cardiac autonomic dysfunction.
Two patients with the acquired immune deficiency syndrome developed acute pulmonary edema following intravenous fluid administration. Both recovered with diuretic therapy. In neither case was there evidence of persistent severe left ventricular dysfunction, nor was there evidence (either clinically or by thallium study) of flow limiting coronary lesions or of cardiac uptake of iodine-123 meta-iodobenzylguanidine, pointing to ventricular sympathetic neuropathy. It is hypothesized that destruction of the cardiac sympathetics contributed importantly to the development of pulmonary edema following the intravenous fluid load.
Palaic
M
M
Cardiology Division, Royal Victoria Hospital, McGill University, Montreal, Quebec.
Lisbona
R
R
Sniderman
A D
AD
D019797:3-Iodobenzylguanidine; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000503:physiopathology; D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000150:complications* / Q000503:physiopathology; D005440:Fluid Therapy / Q000009:adverse effects*; D006321:Heart / Q000000981:diagnostic imaging / Q000294:innervation*; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D011654:Pulmonary Edema / Q000209:etiology*; D011877:Radionuclide Imaging; D013565:Sympatholytics; D013794:Thallium Radioisotopes; D016277:Ventricular Function, Left / Q000502:physiology
D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D013565:Sympatholytics; D013794:Thallium Radioisotopes; D019797:3-Iodobenzylguanidine