To identify patients susceptible to develop unilateral pulmonary edema,
which should be considered among possible differential diagnoses.
To describe the subtle image findings on chest radiography and chest tomography that suggest unilateral pulmonary edema.
To show our experience in the diagnosis of patients with clinical and radiological findings of unilateral pulmonary edema,
in addition to outlining the main causes of this finding.
Acute pulmonary oedema is a manifestation of decompensated heart failure,
the usual radiological pattern in chest X-rays corresponds to bilateral symmetrical opacity occupying the central areas of the lung parenchyma,
hence the classic sign of “butterfly shadow".
There are two types of pulmonary edema:
Pulmonary cardiogenic edema or increased hydrostatic pressure.
Non-cardiogenic pulmonary edema or normal hydrostatic pressure edema due to increased pulmonary permeability,
acute lung injury or acute respiratory distress syndrome.
Cardiogenic Pulmonary edema VSNon-cardiogenic pulmonary edema
Findings and procedure details
66 years old
Personal history of Diabetes Mellitus 2,
Chronic occlusive arterial disease.
She is admitted for marked dyspnea and generalized edema.
Admission Diagnosis: Decompensated Heart Failure - Pulmonary Edema.
Echocardiography: Mixed Cardiopathy (Ischemic and Severe Mitral Valvulopathy) with LVEF25%.
The patient presents important clinical deterioration,
with increased dyspnea and oxygen support requirement at high flow.
With well score of 3,
Thorax CT angiography is ordered due to suspicion of pulmonary embolism.
Coronariography: did not show significant injuries.
Asymmetric pulmonary edema is a rare entity,
with subtle radiologic findings; which leads to misdiagnoses initial delay marked the beginning of an optimal therapeutic,
directly impacting the prognosis of patients.
Although this entity is strongly associated with severe mitral valve disease,
this is not the only cause; so a high clinical and radiological suspicion is essential for accurate diagnosis.
Cardiac Unilateral Pulmonary Edema: Is It Really a Rare Presentation?.
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Edema pulmonar unilateral; una rara presentación de...