Postoperative pulmonary edema in preclinical heart failure with preserved ejection fraction

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  • 術後に肺水腫を生じた駆出率の保たれた心不全の1症例
  • 症例報告 術後に肺水腫を生じた駆出率の保たれた心不全の1症例
  • ショウレイ ホウコク ジュツゴ ニ ハイ スイシュ オ ショウジタ クシュツリツ ノ タモタレタ シンフゼン ノ 1 ショウレイ

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Abstract

<p>　A 76-year-old woman with an ovarian tumor underwent elective laparoscopic salpingo-oophorectomy under general anesthesia. Although she showed an elevated level of N-terminal pro-brain natriuretic peptide and left ventricular diastolic dysfunction, she had no apparent symptoms of heart failure in the preoperative period. Immediately after surgery, rapid-onset pulmonary edema developed. Administration of a diuretic resolved the pulmonary edema, and she had an uneventful course without any other complications. This case was considered to be preclinical heart failure with a preserved ejection fraction. Because there were no apparent symptoms of heart failure in the preoperative period, we underestimated the risk of perioperative pulmonary edema and failed to prevent it. In patients who have heart failure with a preserved ejection fraction, increases in load can lead to rapid-onset pulmonary edema even without symptoms of heart failure. This case indicates that detailed preoperative evaluation, treatment of volume overload in advance, and perioperative management under the condition of appropriate monitoring may be important for the prevention of perioperative pulmonary edema in patients who have suspected heart failure with a preserved ejection fraction.</p>

Journal

  • Cardiovascular Anesthesia

    Cardiovascular Anesthesia 22 (1), 145-149, 2018-08-01

    Japanese Society of Cardiovascular Anesthesiologists

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