What Are the Symptoms of Flash Pulmonary Edema?

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Q:
What are the symptoms of flash pulmonary edema?

A:
Complaints of severe cough and dyspnea are usually the primary symptoms on presentation of flash pulmonary edema with or without chest discomfort. Common findings on physical examination include:

  • Tachypnea – with use of accessory muscles of breathing.
  • Lung fields – auscultation of crackles in bases and scattered throughout the lung fields, rales or even decreased breath sounds.
  • Cardiac exam – possible presence of an S3 indicating an increase in left ventricular end diastolic volume or an S4 gallop coinciding with an increase in left atrial pressure, and a new or changed murmur.
  • Jugular venous distension indicating increased filling pressures.
  • Systolic Blood pressure – may be markedly elevated. Hypotension suggests left ventricular systolic dysfunction and impending cardiogenic shock.
  • Peripheral edema – usually without signs of edema, if present, then associated with longstanding volume expansion.

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