Pulmonary Edema in Coronary-Artery Disease without Cardiomegaly

ACUTE pulmonary edema usually is accompanied by cardiomegaly unless it is of noncardiac origin, or occurs in special cases of heart failure1,2 such as restrictive cardiomyopathy, mitral stenosis, aortic stenosis, paroxysmal tachyarrhythmia and acute myocardial infarction. However, it has not generally been appreciated that recurrent pulmonary edema with clinically and radiographically normal heart size may characterize a syndrome in the spectrum of coronary-artery disease. This is not altogether unexpected in view of the observations of high left ventricular end-diastolic pressure in the normovolumic ventricle of noncongested patients with ischemic heart disease.3,4This report details the clinical manifestations and the . . .