Pulmonary edema is a circulatory abnormality of the pulmonary circulation with multiple causes, but most commonly due to left ventricular failure and resulting in the accumulation of fluid in the interstitium and alveoli of the lungs .
Clinically it results in shortness of breath, coughing, coughing up blood, breathing difficulty, wheezing, sweating, skin paleness, nasal flaring, and behavioral problems.
It is diagnosed clinically by observation, listening to respiratory sounds, oxygen level measurement, chest x-ray, and ultrasound.
Treatment includes the administration of oxygen, diuretic and cardiac support and if severe may require intubation, and ventilatory support.
Dilated Cardiomyopathy Chronic renal Failure
34-year-old male has a normal appearing CXR 1 year before presentation
At the time of his first presentation with dyspnea his CXR showed perihilar infiltrates.
A CT confirmed progressive alveolar edema, with bilateral effusions (right greater than left), mild left ventricular dilatation, Kerley B lines and centrilobular densities and small pericardial effusion.
1 month after this admission a treadmill stress and rest gated SPECT study showed no evidence of ischemia with a calculated ejection fraction of 31%
MRI confirmed the presence of a dilated cardiomyopathy, small pericardial effusion, without evidence of LGE, global hypokinesis and EF of about 20%
Pulmonary Edema, Thickened Interlobular Septa and Crazy Paving