Negative pressure pulmonary edema (NPPE) is defined as fluid transudation into the pulmonary interstitium which occurs as a result of elevated negative intrathoracic pressure caused by the upper respiratory tract obstruction and strong inspiratory effort. NPPE is usually seen during emergence from general anesthesia in the early post-operative period especially after upper respiratory tract surgery. We present a case of a 37-year-old male patient who underwent septoplasty operation and developed NPPE which could not diagnosed and progressed to acute subendocardial myocardial infarction.
Introduction: Eventration of the diaphragm is a disorder in which all or part of the diaphragmatic muscle is replaced by fibroelastic tissue. The incidence of evantration is uncertain, although one paper reports that this entity is detected in 1 per 1400 chest radiographies. This article reports a case of right-sided eventration of diaphragm in 70 years old obese woman who was admitted to our institution with complaints of recurrent cough and sweating. Case report: A 70 year-old obese woman was admitted to Izmir Tepecik Education and Research Hospital Family Medicine Obesity Polyclinic with complaints of recurrent cough and sweating symptoms for the last few months. Reduction in lungs sounds on the right side and dullness were detected by the physical examination. X-ray chest in posteroanterior (PA) and lateral view exhibited elevation of the right diaphragm. During hospitalization patient was treated with Valsartan (320 mg) + Hydrochlorotiazide (12,5 mg) combination for hypertension; atorvastatine 40 mg for hyperlipidemia; asetylsistein for productive cough and alginic acid as an antacid. She had had a 1800 kilocalories diet without salt. Upper respiratory tract symptoms were regressed and blood pressure was at the normal range. She was hospitalized for 15 days for diagnosis and weight reduction as well. Thus; the patient was discharged from the institution with the information about diaphragm eventration and obesity, and advised of their symptoms, warnings and guarding herself against trauma, and referred to Chest Diseases polyclinic. Conclusion: Respiratory symptoms such as recurrent cough and upper respiratory infections are the most common complaints in the patients' visits to family medicine practitioners. Although eventration of the diaphragm is rarely seen and usually is asymptomatic; it should be kept in mind as a reason of recurrent cough especially in obese patients who have vertebral pathologies or history of surgery.
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