Negative pressure pulmonary edema in the coronary care unit.
A 63-year-old woman with no known cardiac history presented with pulmonary edema accompanied by electrocardiographic evidence of ischemia. Echocardiography demonstrated normal cardiac dimensions, normal wall motion and mild diastolic dysfunction. Despite repeat attempts at extubation following aggressive diuresis, the patient required ongoing ventilatory support. Although cardiac catheterization revealed normal coronary arteries, computed tomography revealed a 4 cm 9 cm multinodular goiter extending into the mediastinum and compressing the trachea. A diagnosis of negative pressure pulmonary edema should be considered in the differential diagnosis of any patient presenting with acute heart failure.
Schaffer
Stephen A
SA
Department of Cardiac Sciences, University of Manitoba, Winnipeg, Canada.
Manji
Rizwan A
RA
Kirkpatrick
Iain
I
Fang
Tielan
T
Arora
Rakesh C
RC
Zieroth
Shelley
S
Jassal
Davinder S
DS
D003325:Coronary Care Units; D004417:Dyspnea / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D006044:Goiter, Nodular / Q000000981:diagnostic imaging* / Q000601:surgery; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D011654:Pulmonary Edema / Q000175:diagnosis* / Q000601:surgery; D013965:Thyroidectomy; D014057:Tomography, X-Ray Computed; D014135:Tracheal Stenosis / Q000209:etiology / Q000601:surgery
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