An Adult with Acute Breathlessness and Unilateral Diffuse Alveolar Opacities

Cardiogenic pulmonary edema is typically bilateral and results from the accumulation of excessive fluid in the interstitial and alveolar spaces of the lungs caused by left ventricular failure. Cardiogenic unilateral pulmonary edema (CUPE) is uncommon and most often documented in severe mitral regurgitation. CUPE in other cardiac diseases such as coronary artery disease is rare and occasionally associated with prolonged lateral decubitus position or vascular perfusion mismatch between lungs either congenital such as pulmonary artery agenesis or acquired due to preexisting lung conditions such as compensatory emphysema following lobectomy. The radiologic opacities of CUPE does not have characteristic features as described with bilateral pulmonary edema. The possibility of CUPE is often not considered initially as its clinical/radiologic features often resemble or are mistaken as pneumonia resulting in diagnostic delay and higher mortality.