Acute Heart Failure With Unilateral Pulmonary Edema Due to Aortic Insufficiency During LVAD Support

Enklajd Marsela; Omar Saeed; Snehal R Patel; Ulrich P Jorde

doi:10.1016/j.jaccas.2024.102584

Acute Heart Failure With Unilateral Pulmonary Edema Due to Aortic Insufficiency During LVAD Support

JACC Case Rep. 2024 Oct 2;29(19):102584. doi: 10.1016/j.jaccas.2024.102584.

Authors

Enklajd Marsela¹, Omar Saeed¹, Snehal R Patel¹, Ulrich P Jorde¹

Affiliation

¹ Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.

Abstract

Unilateral pulmonary edema (UPE) is a rare manifestation of cardiogenic pulmonary edema that is often confused with other causes of unilateral pulmonary infiltrates. A 47-year-old female with a HeartWare left ventricular assist device (LVAD) presented with dyspnea and UPE. Right heart catheterization revealed inadequate left ventricular unloading in the setting of aortic insufficiency and facilitated LVAD speed adjustment leading to resolution of symptoms. Timely diagnosis of UPE is critical because it is related to an independent increased risk of mortality, likely due to initial misdiagnosis and delayed proper treatment. The increasing use of LVADs in patients with advanced heart failure necessitates a thorough understanding of potential device complications and their management.

Keywords: acute heart failure; aortic valve; cardiac assist devices; hemodynamics; insufficiency; pulmonary edema.

Publication types

Case Reports