Intensive Care Unit, Dongyang People's Hospital, Dongyang, Zhejiang, PR China.
Medicine (Baltimore). 2021 Feb 19;100(7):e24622. doi: 10.1097/MD.0000000000024622.
Unilateral cardiogenic pulmonary edema is a rare disease. A common cause is mitral valve and asymmetrical blood regurgitation that is primarily directed toward the upper right pulmonary vein, causing mean capillary pressure to increase on the right side and leading to right pulmonary edema.
A 41-year-old man was diagnosed with pneumonia after presenting with a 2-day history of cough and shortness of breath. Computed tomography indicated right pulmonary edema. He was managed with noninvasive ventilation; however, his condition continued to deteriorate, and he was transferred to the intensive care unit after tracheal intubation.
Acute posterior mitral valve prolapses; unilateral cardiogenic pulmonary edema.
Emergency mitral valve replacement was performed. During the operation, 2 ruptures of the chordae tendineae in the P2 scallop of the posterior mitral valve were found, and a No. 29 St. Jude mechanical mitral valve was implanted.
Cardiotonic and diuretic drugs were administered postoperatively. Tracheal intubation was removed on day 7; the patient was transferred to the general ward on day 11 and discharged on day 23 postoperatively.
Unilateral cardiogenic pulmonary edema is easily misdiagnosed. Computed tomographic (CT) imaging presentation, brain natriuretic peptide, and cardiac color Doppler ultrasound can assist in determining a differential diagnosis. Early surgical treatment is recommended for patients with acute mitral valve prolapse.
单侧心源性肺水肿是一种罕见疾病。常见病因是二尖瓣和不对称性血液反流，主要流向右上肺静脉，导致右侧肺毛细血管平均压升高，引起右侧肺水肿。
一名 41 岁男性因咳嗽和呼吸急促 2 天就诊，被诊断为肺炎。计算机断层扫描提示右侧肺水肿。他接受了无创通气治疗；然而，他的病情持续恶化，在气管插管后被转至重症监护病房。
急性后外侧二尖瓣脱垂；单侧心源性肺水肿。
紧急行二尖瓣置换术。术中发现后外侧二尖瓣 P2 瓣叶的 2 条腱索断裂，植入了 29 号圣犹达机械二尖瓣。
术后给予强心和利尿剂治疗。术后第 7 天拔除气管插管；第 11 天患者转至普通病房，第 23 天出院。
单侧心源性肺水肿易误诊。计算机断层扫描（CT）成像表现、脑利钠肽和心脏彩色多普勒超声有助于确定鉴别诊断。对于急性二尖瓣脱垂患者，建议早期手术治疗。
