Negative pressure pulmonary edema may present as acute left ventricular failure: a case report

Abstract

Negative pressure pulmonary edema (NPPE) also known as post obstructive pulmonary edema is a potentially life threatening condition with a multifocal pathogenesis. Type 1 NPPE is due to forceful inspiratory effort in the context of an acute airway obstruction, while Type 2 NPPE occurs after relief of a chronic partial upper airway obstruction. Once developed, it impairs gas exchange and causes hypoxemia and if not treated promptly may lead to respiratory failure. The diagnosis of negative pressure pulmonary edema is usually made on the basis of a history of a precipitating incident and symptoms. However, it is basically a diagnosis of exclusion. We present here a case of negative pressure pulmonary edema, which presented as acute left ventricular failure. The cause was eventually found to be acute airway obstruction due to an obstructive goiter precipitated by an upper respiratory tract infection.