Unilateral Pulmonary Edema

Calenoff, Leonid; Kruglik, Gerald D.; Woodruff, A

doi:10.1148/126.1.19

Cited by 63 publications

(20 citation statements)

References 18 publications

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“…Elevated hydrostatic pressure can result from obstructive lesions of the pulmonary veins, left atrium or mitral valve, or even from dysfunction of the left ventricle, the most common cause being a reduction in the compliance of the left ventricle and increased end-diastolic pressure, which is retrogradely transmitted to the pulmonary venous microcirculation. (3,5) Classically, two physiopathological and radiological phases of hydrostatic pulmonary edema are recognized: interstitial edema and alveolar edema. (1,3,6,9) The first phase is characterized by interstitial edema, which is secondary to the transudation of fluid from the vascular space to the interstitium, due to increased capillary pressure.…”

Section: Discussionmentioning

confidence: 99%

“…(1,5) There are other causes, although of lesser prevalence, that lead to pulmonary venous obstruction, which is in turn accompanied by hydrostatic edema. (1,3,5) Although the radiological aspects of hydrostatic edema have been extensively studied, the tomographic findings, especially those from highresolution computed tomography scans, have received little attention. Nevertheless, knowledge of such findings is important for making the differential diagnosis with other lung diseases, as well as for, under certain circumstances, avoiding unnecessary lung biopsies.…”

Section: Introductionmentioning

confidence: 99%

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Edema pulmonar hidrostático: aspectos na tomografia computadorizada de alta resolução

et al. 2006

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Objective: This study aimed to use high-resolution computed tomography scans of the chest to characterize the principal alterations occurring in cases of hydrostatic pulmonary edema. Methods: A retrospective analysis was made of the tomography scans of 15 patients presenting clinical profiles of hydrostatic pulmonary edema. The cases were divided into five groups by etiology: congestive heart failure (n = 7); acute mitral valve disease (n = 2); acute myocardial infarction (n = 2); myocarditis (n = 2); and fibrosing mediastinitis (n = 2). Results: The principal findings in the cases of hydrostatic pulmonary edema were ground-glass opacities (in 100%), interlobular septal thickening (in 100%), pleural effusion (in 87%) and peribronchovascular interstitial thickening (in 80%). Other, less common, findings were increased blood vessel diameter, consolidations and air-space nodules. Conclusion: The predominant pattern found in the patients studied was that of ground-glass opacities accompanied by interlobular septal thickening (mosaic attenuation pattern) and bilateral (predominantly right-sided) pleural effusion.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Edema pulmonar hidrostático: aspectos na tomografia computadorizada de alta resolução

et al. 2006

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“…16,17 We found that the unilateral pulmonary edema occurring in obstetric patients had a cardiogenic cause and 3 out of the 4 patients lay in a right lateral position for a long time before admission because the position relieved the dyspnea. Therefore, we speculate that unilaterally increased hydrostatic pressure contributed to the occurrence of unilateral pulmonary edema even though the reason why the right decubitus position relieved the dyspnea remains unclear.…”

Section: Discussionmentioning

confidence: 88%

Pulmonary Edema During Pregnancy. Unilateral Presentation Is Not Rare.

Choi

Han

et al. 2002

Circ J

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uring the past 20 years, the incidence, 1,2 cause and associated clinical conditions, 2-8 and clinical course 2,9 of obstetric pulmonary edema have been reported. Pulmonary edema during pregnancy can be lifethreatening and patients are usually transferred to tertiary care centers, so most of the medical literature is based on the experiences of the tertiary care centers. Hence, there is limited information on the natural history of pulmonary edema from its onset to its resolution because of a possible selection bias in previous studies.The primary purpose of our study was therefore to determine the incidence, etiology and course of pulmonary edema in all obstetric patients at our primary -secondary care center during the past 3.5 years. We analyzed (1) the clinical conditions associated with the onset of pulmonary edema, (2) the etiologic diagnosis made by echocardiography within 2 days of onset and (3) the X-ray pattern and rate of resolution. MethodsWe studied prospectively patients with pulmonary edema among 29,621 obstetric cases at the Samsung Cheil Hospital and Women's Healthcare Center between March 1, 1998 and June 31, 2001. Pulmonary edema was diagnosed on the basis of a history of dyspnea, pulmonary rales, hypoxemia (PaO2 <80 mmHg or SataO2 <90% with room air), and airspace opacities on the chest radiograph consistent with Circulation Journal Vol.66, July 2002 pulmonary edema. Cases of initially atypical X-ray presentation were also included when clinical symptoms and signs and the X-ray infiltration improved rapidly with treatment for pulmonary edema such as diuretics, inotropics, or both.We collected data from the time when pulmonary edema was suspected. The chest was radiographed and pulse oximetry was monitored for all patients with severe dyspnea and pulmonary rales. To elucidate the cause we reviewed the medical history for the presence of pre-existing cardiac or hypertensive disease, diagnosis of twin gestation, preterm labor, pre-eclampsia, treatment with steroids, MgSO4 ormimetics, evidence of infection, and volume overload. Within 2 days of the onset of pulmonary edema, 2-dimensional and M-mode echocardiography with Doppler study were performed using a Hewlett-Packard (Sonos 1000, USA) echocardiograph to assess left ventricular systolic and diastolic function. Peripartum cardiomyopathy was diagnosed on the basis of the echocardiographic findings. 10 Diastolic heart failure was diagnosed from a transmitral flow study when the E/A ratio was less than 1 in the presence of a deceleration time (DT) greater than 220 ms, or if the isovolumetric relaxation time (IVRT) was greater than 100 ms with normal systolic function. 11 Pre-eclampsia was diagnosed on the basis of ACOG clinical criteria. 12 During treatment of pulmonary edema, a chest X-ray was performed every 1 or 2 days. When patients were transferred to tertiary centers, we obtained follow-up information from the doctors by telephone contact. ResultsPulmonary edema developed in 18 cases (0.06%) of all obstetric patients (Table 1). The mean ma...

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“…Ipsilateral pulmonary oedema occurs on the same side as a focal insult to one lung without evidence of oedema in the other lung. The main causes of this type of oedema include bronchial obstruction, veno-occlusive disease, unilateral aspiration, pulmonary contusions, mitral regurgitation and several others [7]. The second classification, contralateral pulmonary oedema, is oedema that occurs in a normal lung only as a result of an abnormality in the opposite lung.…”

Section: Discussionmentioning

confidence: 99%

Localised right upper-lobe pulmonary oedema caused by extension of giant cell carcinoma to the mitral valve

Ono

Okada²,

Ando³

et al. 2011

BJR

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ABSTRACT. Giant cell carcinoma of the lung is a very rare primary malignant tumour and localised right upper-lobe pulmonary oedema is also unusual. We report a case of giant cell carcinoma, which invaded the left atrium through the left pulmonary vein and caused localised right upper-lobe pulmonary oedema. Giant cell carcinoma of the lung is a very rare primary malignancy associated with highly aggressive clinical behaviour and poor prognosis. To our knowledge very few CT images of patients with pulmonary giant cell carcinoma have been reported. Furthermore, localised right upper-lobe pulmonary oedema is also unusual. The case presented here exhibited clinical, radiographic and pathophysiological features of right upper-lobe pulmonary oedema. We report a case of localised right upperlobe pulmonary oedema caused by extension of giant cell carcinoma to the mitral valve. Case reportA 54-year-old man presented with an increasing cough and haemoptysis for 2 weeks. His past medical history included prior myocardial infarction and he underwent coronary artery bypass graft surgery 7 years ago. He had no history of pleuropulmonary disease. He was an alcoholic with a daily consumption of alcohol of more than 80 g during the past 10 years and had smoked for more than 10 pack-years (1 pack-year is an average of 1 pack of cigarettes smoked per day for a year).A chest radiograph showed complete opacification of the left hemithorax and elevation of the left diaphragm (not shown). Contrast chest thin-section CT images showed an ill-defined huge mass with extensive necrosis in the left lower lobe and multiple mediastinal and hilar lymph node enlargement (not shown). The left main bronchus was obstructed by a tumour with resultant left lung atelectasis. Moreover, the tumour had invaded the left atrium through the left pulmonary vein. Histopathological examination of a transbronchial biopsy showed non-small cell carcinoma (not shown).Although chemotherapy was administered to the patient, the tumour grew rapidly. A chest radiograph, which was obtained 1 month after the initial chest radiograph, revealed airspace shadowing confined to the right upper lung field (Figure 1). Contrast-enhanced thin-section CT images showed that the masses in the left lung, the left main bronchus and the left inferior pulmonary vein had increased in size (not shown). In addition, the tumour in the left atrium had also grown and the mitral valve dilated with invasion into the left ventricle (Figure 2). The CT images showed localised consolidation with air bronchogram in the right upper lobe, which was thought to be localised pulmonary oedema caused by mitral valve regurgitation owing to tumour progression to the left ventricle (Figure 3). In addition, metastatic right pulmonary small nodules and bilateral adrenal masses were observed on CT images (not shown).One week later the patient died of massive haemoptysis. The autopsy revealed that the left huge mass had invaded the left pulmonary vein, the left atrium and the left ventricle, and caused mitral val...

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Unilateral Pulmonary Edema

Cited by 63 publications

References 18 publications

Edema pulmonar hidrostático: aspectos na tomografia computadorizada de alta resolução

Edema pulmonar hidrostático: aspectos na tomografia computadorizada de alta resolução

Pulmonary Edema During Pregnancy. Unilateral Presentation Is Not Rare.

Localised right upper-lobe pulmonary oedema caused by extension of giant cell carcinoma to the mitral valve

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