A Patient comes with sudden respiratory distress. On examination, bilateral basal crepts are present over chest suggestive of pulmonary edema. Alveolar wedge pressure is normal. The likely cause is?
Answer is A (Narcotic overdose) Pulmonary edema with normal pulmonary capillary wedge pressure suggests a diagnosis of ARDS or non cardiogenic pulmonary edema. Narcotic overdose is the only non cardiogenic cause for pulmonary edema (ARDS) amongst the options provided and hence the answer here. Direct Lung Injury Pneumonia Aspiration of gastric contents Pulmonary contusion Near drowning Toxic inhalation injury Indirect lung injury Sepsis Severe trauma: - Multiple bone fractures - Head trauma - Flail chest Burns Multiple tramsfusionse Drug overdose: eg Narcotic overdose Pancreatitise Post-cardiopulmonary bypass Miscellaneous causes Renal failure Liver failure Disseminated intravascular coagulation Ecclampsiae Amniotic fluid emboli /Air embolideg Hanging High altitude Causes of Pulmonary Edema with Normal Pulmonary Capillary Wedge pressure (PCWP=Normal)
Narcotic overdose
Congestive hea failure
Myocardial infarction
Cardiogenic shock