Unilateral pulmonary edema in a patient with ischemic heart failure

A 72-year-old woman with a history of anterolateral myocardial infarction was in severe respiratory distress with frothy sputum production. Electrocardiogram and echocardiogram detected evidence of ischemic change due to anterolateral myocardial injury. Chest roentogenogram showed unilateral, right side pulmonary edema with a clear left lung field. Mechanical ventilation and diuretic administration contributed to her recovery from heart failure and pulmonary edema. Computed tomographic scan showed no abnormality of the bilateral lung fields or pulmonary vasculature; however, pulmonary perfusion scan and pulmonary angiography revealed reduced blood perfusion in the entire left lung field. Although we have no histological evidence, some pulmonary parenchymal change on the left side might have been the cause of unilateral pulmonary edema in this case. In conclusion, a woman with ischemic heart failure developed unilateral pulmonary edema on the right side, showing reduced blood perfusion on the left side.