[Acute pulmonary edema with pseudohypotension]. / Edema polmonare acuto con pseudoipotensione.
Ital Heart J Suppl
; 2(9): 1023-5, 2001 Sep.
Article
em It
| MEDLINE
| ID: mdl-11675824
ABSTRACT
A 69-year-old male was admitted to our Coronary Care Unit because of increasing dyspnea in a non-Q wave myocardial infarction complicated by severe heart failure. Physical examination revealed dyspnea, cyanosis, sweat, bilateral crepitations on the whole chest and severe hypotension (blood pressure 80/40 mmHg on the left arm and 90/55 mmHg on the right arm). A coronarographic examination was performed as the patient's clinical status worsened despite an appropriate treatment of the hemodynamic impairment with vasoactive drugs. It showed no hemodynamically significant coronary stenosis and an elevated left ventricular systolic pressure (180/200 mmHg). An obstruction of the vascular district of both arms was diagnosed as the underlying cause of such relevant difference between the left ventricular and humeral blood pressures. A computed tomographic spiral scan of the chest confirmed the presence of a bilateral subclavian artery from the aortic arch and an atheromatous substenosis of the right subclavian artery. The subsequent evaluation of the blood pressure at the lower limbs showed values of systolic blood pressure > 220 mmHg, while the values at upper limbs were persistently < 90 mmHg. In conclusion, careful evaluation of the blood pressure at all four limbs is necessary in all patients with suspected peripheral vascular disease in which a single determination may be misleading.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Arteriosclerose
/
Edema Pulmonar
/
Artéria Subclávia
/
Dispneia
/
Hipotensão
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
Limite:
Aged
/
Humans
/
Male
Idioma:
It
Revista:
Ital Heart J Suppl
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2001
Tipo de documento:
Article