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March 1987

Pulmonary Edema Associated With Subarachnoid Hemorrhage: Evidence for a Cardiogenic Origin

Author Affiliations

From the Department of Medicine, Coney Island Hospital, Brooklyn, NY (Drs Schell, Shenoy, Friedman, and Patel), and the Department of Medicine, State University of New York Health Science Center at Brooklyn (Drs Shenoy and Friedman).

Arch Intern Med. 1987;147(3):591-592. doi:10.1001/archinte.1987.00370030189037

• A 56-year-old woman with no history of cardiac disease developed acute pulmonary edema following a subarachnoid hemorrhage. A constellation of findings, including elevated creatine kinase MB isoenzyme activity in the absence of electrocardiographic or scintigraphic evidence of acute myocardial infarction, elevated pulmonary artery wedge pressure, segmental wall motion abnormalities, and depressed ejection fraction of the left ventricle demonstrated by two-dimensional echocardiography and radionuclear ventriculography, pointed to a direct myocardial injury leading to cardiac failure. The evidence for cardiogenic origin of pulmonary edema provided by this case is in contrast to the belief that "neurogenic" pulmonary edema is of noncardiac origin.

(Arch Intern Med 1987;147:591-592)

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