ABSTRACT
A 63-year-old woman with no known cardiac history presented with pulmonary edema accompanied by electrocardiographic evidence of ischemia. Echocardiography demonstrated normal cardiac dimensions, normal wall motion and mild diastolic dysfunction. Despite repeat attempts at extubation following aggressive diuresis, the patient required ongoing ventilatory support. Although cardiac catheterization revealed normal coronary arteries, computed tomography revealed a 4 cm 9 cm multinodular goiter extending into the mediastinum and compressing the trachea. A diagnosis of negative pressure pulmonary edema should be considered in the differential diagnosis of any patient presenting with acute heart failure.
Subject(s)
Goiter, Nodular/diagnostic imaging , Pulmonary Edema/diagnosis , Coronary Care Units , Dyspnea/etiology , Electrocardiography , Female , Goiter, Nodular/surgery , Heart Failure/etiology , Humans , Middle Aged , Pulmonary Edema/surgery , Thyroidectomy , Tomography, X-Ray Computed , Tracheal Stenosis/etiology , Tracheal Stenosis/surgeryABSTRACT
Pulmonic valvular stenosis represents the most frequent cause of right ventricular outflow obstruction. Transthoracic echocardiography is the imaging modality of choice in the diagnosis, evaluation and longitudinal follow-up of individuals with pulmonic stenosis (PS). Although valvular PS is usually diagnosed by two-dimensional imaging, Doppler echocardiography allows for the quantification of severity of the valvular lesion. In patients with limited acoustic windows, computed tomography and cardiac magnetic resonance imaging may provide complementary anatomical characterization of the pulmonic annulus and valve prior to percutaneous balloon valvuloplasty.
