Tuberc Respir Dis.  2005 Oct;59(4):432-435.

Localized Pulmonary Edema in Patient with Severe Mitral Regurgitation

• Yoon YG
• Bang DS
• Park BC
• Lee SH
• Kim JS
• Park Y
• Hong YC
• Ko KT
• Park SM
• Han SH
• Park SH
• Lim JC
• Na DJ

Abstract

An 82-year-old female non-smoker with a history of hypertension presented with increasing dyspnea, cough and some purulent sputum without fever. Upon admission, the patient was in a distressed condition. Auscultation revealed diminished breath sounds with no rales over the right lung. An examination of the heart revealed a regular rhythm and a systolic murmur radiating from the apex of the heart. There was no pitting edema in the lower extremities. The blood tests showed mild leukocytosis and an increased C-reactive protein level. The O2 saturation was 98 % whilst breathing room air. The electrocardiogram demonstrated sinus tachycardia. The chest radiograph showed a moderate cardiomegaly, right lobe infiltrates, and blunting of the both costophrenic sulcus suggesting a small pleural effusion. Three days after admission, the symptoms became slightly aggravated despite being treated with empirical antibiotics for presumed community-acquired pneumonia. Transthoracic color Doppler echocardiography indicated an ejection fraction of 48 %, mild left ventricular enlargement, and moderate left atrial enlargement resulting in severe mitral regurgitation. The clinical symptoms and right pulmonary edema resolved quickly with intravenous furosemide treatment.

Keyword

Pulmonary edema; Mitral regurgitation

MeSH Terms

Aged, 80 and over
Anti-Bacterial Agents
Auscultation
C-Reactive Protein
Cardiomegaly
Cough
Dyspnea
Echocardiography, Doppler, Color
Edema
Electrocardiography
Female
Fever
Furosemide
Heart
Hematologic Tests
Humans
Hypertension
Leukocytosis
Lower Extremity
Lung
Mitral Valve Insufficiency*
Pleural Effusion
Pneumonia
Pulmonary Edema*
Radiography, Thoracic
Respiration
Respiratory Sounds
Sputum
Systolic Murmurs
Tachycardia, Sinus
Anti-Bacterial Agents
C-Reactive Protein
Furosemide