Pulmonary edema

Case contributed by Dr Calum Worsley

Presentation

Two weeks of chest pain and worsening breathlessness.

Patient Data

Age: 90 years
Gender: Male
X-ray

Patchy perihilar opacification, upper lobe venous diversion, and trace fluid in the horizontal fissure are in keeping with pulmonary edema.

Degenerative change at the right acromioclavicular joint.

Case Discussion

The patient had a raised troponin and was treated for non-ST elevation myocardial infarction. After a trial of medical management, he underwent coronary angiography and had a stenosed left anterior descending artery stented.

Pulmonary edema as seen in this case is a common feature of acute coronary syndromes, as the reduced pumping efficiency of the ischemic heart muscle causes buildup of fluid in the pulmonary vasculature.

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