Abstract
Pulmonary oedema is a very common clinical presentation in the hospital setting with the management steps memorised by most medical student from an early stage. This management works on the basis that the patient is fluid overloaded from left ventricular systolic dysfunction (LVSD). In reality however, this is not always the case with diastolic dysfunction also causing pulmonary oedema. In the case of diastolic dysfunction there is little data to guide management.1 We present a case of a patient who developed flash pulmonary oedema (FPO) secondary to a hypertensive crisis.
References
Eagle KA, Quertermous T, Singer DE, et al. Left ventricular ejection fraction: physician estimates compared with gated blood pool scan measurements. Arch Int Med 1988;148: 882–5.
Eagle KA, Quertermous T, Singer DE, et al. Left ventricular ejection fraction: physician estimates compared with gated blood pool scan measurements. Arch Int Med 1988;148: 882–5.
Delis KT, Gloviczki P. Middle aortic syndrome: from presentation to contemporary open surgical and endovascular treatment. Perspect Vasc Surg Endovasc Ther 2005;17:187–203. Available from: https://doi.org/10.1177/153100350501700302
Connolly JE, Wilson SE, Lawrence PL, Fujitani RM. Middle aortic syndrome: distal thoracic and abdominal coarctation, a disorder with multiple etiologies. J Am Coll Surg 2002;194: 774–81. Available from: https://doi.org/10.1016/s1072-7515(02)01144-4
Chitrakar A, Shrestha KR, Shrestha UK. Middle aortic syndrome with renal artery stenosis. J Surg Case Rep. 2017 Sep 29;2017(9):rjx177. https://doi.org/10.1093/jscr/rjx177.
Messina LM, Reilly LM, Goldstone J, Ehrenfeld WK, Ferrell LD, Stoney RJ. Middle aortic syndrome. Effectiveness and durability of complex arterial revascularization techniques. Ann Surg 1986;204:331–9. Available from: https://doi.org/10.1097/00000658-198609000-00012.
Taketani T, Miyata T, Morota T, Takamoto S. Surgical treatment of atypical aortic coarctation complicating Takayasu’s arteritis: experience with 33 cases over 44 years. J Vasc Surg 2005;41:597–601. Available from: https://doi.org/10.1016/j.jvs.2005.01.022
Little WC. Hypertensive pulmonary oedema is due to diastolic dysfunction. European Heart Journal 2001;22:1961-1964. Available from: https://doi.org/10.1053/euhj.2001.2665
Gandhi SK, Powers JC, Nomeir AM, et al. The pathogenesis of acute pulmonary edema associated with hypertension. N Engl J Med 2001; 344:17-22. Available from: https://doi.org/10.1056/NEJM200101043440103
Heitzer T, Just H, Brockhoff C, et al. Long-term nitroglycerin treatment is associated with supersensitivity to vasoconstrictors in men with stable coronary artery disease: prevention by concomitant treatment with captopril. J Am Coll Cardiol. 1998;31:83e88. Available from: https://doi.org/10.1016/s0735-1097(97)00431-2
Kramer K, Kirkman P, Kitzman D, Little WC. Am Heart J 2000;140: 451–5. Available from: https://doi.org/10.1067/mhj.2000.108828
Syammakh MH, Anthonius FR Hypertensive crisis induced pulmonary oedema in emergency care unit Sumbawa hospital: a case report, International Journal of Research in Medical Sciences 2018;6(12): 4122-4127. Available from: https://doi.org/10.18203/2320-6012.ijrms20184919
Gavras H, Brunner HB, Vaughan ED, Laragh JH. Angiotensin-sodium interaction in blood pressure maintenance of renal hypertensive and normotensive rats. Science 1973;180:1369-1371. Available from: https://doi.org/10.1126/science.180.4093.1369
Avolio AP, Deng FQ, Li WQ, et al. Effects of aging on arterial distensibility in populations with high and low prevalence of hypertension: comparison between urban and rural communities in China. Circulation 85;71:202-210. Available from: https://doi.org/10.1161/01.cir.71.2.202
Laurent S. Arterial wall hypertrophy and stiffness in essential hypertensive patients. Hypertension 1995;26:355- 362. Available from: https://doi.org/10.1161/01.hyp.26.2.355
Roman MJ, Pickering TG, Schwartz JE, Pini R, Devereux RB. Relation of arterial structure and function to left ventricular geometric patterns in hypertensive adults. J Am Coll Cardiol 1996;28:51-756. Available from: https://doi.org/10.1016/0735-1097(96)00225-2
Grisk O, Rettig R. Interactions between the sympathetic nervous system and the kidneys in arterial hypertension. Cardiovasc Res 2004;61:238-246. Available from: https://doi.org/10.1016/j.cardiores.2003.11.024
Messerli FH, Bangalore S, Makani H, et al. Flash pulmonary oedema and bilateral renal artery stenosis: the Pickering Syndrome. European Heart Journal 2001;32(18):2231–2235. Available from: https://doi.org/10.1093/eurheartj/ehr056
Rimoldi SF, Yuzefpolskaya M, Allemann Y, Messerli F. Flash pulmonary edema. Prog Cardiovasc Dis 2009;52:249- 259. Available from: https://doi.org/10.1016/j.pcad.2009.10.002
Mebazaa A, Gheorghiade M, Piña IL, et al. Practical recommendations for prehospital and early in-hospital management of patients presenting with acute heart failure syndromes. Crit Care Med 2008;36(1 Suppl):S129–39. Available from: https://doi.org/10.1097/01.CCM.0000296274.51933.4C
Agrawal N, Kumar A, Aggarwal, P Jamshed N. Sympathetic crashing acute pulmonary oedema. Indian J Crit Care Med 2016;20(12):719-723. Available from: https://doi.org/10.4103/0972-5229.195710
West JB, Mathieu-Costello O. Stress failure of pulmonary capillaries in the intensive care setting. Schweiz Med Wochenschr 1992;122:751–7.
Rimoldi SF, Yuzefpolskaya M, Allemann Y, Messerli F. Flash pulmonary edema. Prog Cardiovasc Dis 2009;52:249–59. Available from: https://doi.org/10.1016/j.pcad.2009.10.002
Hsieh Y, Lee T, Kao J, Hsu H, Chong C. Treating acute hypertensive cardiogenic pulmonary edema with high- dose nitroglycerin. Turkish Journal of Emergency Medicine 2018;18(1):34-36. Available from: https://doi.org/org/10.1016/j.tjem.2018.01.004