Skip to Main Content

+

  • • Hypoxemia

    • Rales

++

Epidemiology

+

  • • Post-myocardial infarction patients can present with pulmonary edema

    • Surgical stress or fluid shifts in patients with underlying coronary artery disease

    • Fluid overload

++

Symptoms and Signs

+

  • • Hypoxemia

    • Shortness of breath

    • Rales

    • Presence of third heart sound

++

Laboratory Findings

+

  • • Elevated pulmonary arterial wedge pressures on pulmonary artery catheterization

++

Imaging Findings

+

  • Chest x-ray

    • -Cephalization of blood flow

      -Kerley B lines

      -Perihilar infiltrates

+

  • • Diagnosis often requires the combination of physical exam and invasive monitoring findings

    • Causes can include arrhythmia or muscle failure as the underlying cause of the cardiac dysfunction

+

  • • Physical exam

    • ABG measurements

    • Chest x-ray

+

  • • Minimize fluid intake

    • Minimize salt intake

    • Diuresis

    • Supplemental oxygen

    • Intubation and mechanical ventilation

++

Medications

+

  • • Diuretics

    • Inotropes (rarely indicated)

++

Treatment Monitoring

+

  • • Fluid balance

    • Serial ABG measurements

    • Symptomatic improvement

    • Monitor pulmonary capillary wedge pressure (PCWP)

    • Serial chest films

++

Complications

+

  • • Pneumonia

++

Prognosis

+

  • • Determined by etiology of cardiac insufficiency

++

Prevention

+

  • • Careful attention to fluid balance

++

References

Eastridge BJ et al: Hypotension begins at 110 mm Hg: redefining “hypotension” with data. J Trauma 2007;63:291.  [PubMed: 17693826]
Finfer S et al: A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med 2004;350:2247.  [PubMed: 15163774]

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.