Acute Respiratory Distress Syndrome after Early Successful Primary Percutaneous Coronary Intervention Therapy in Acute Myocardial Infarction: A Case Report

Content Provider	Directory of Open Access Journals (DOAJ)
Author	Ho-Ming Su Wen-Chol Voon Tsung-Hsien Lin Chih-Sheng Chu Sheng-Hsiung Sheu Wen-Ter Lai
Abstract	Acute respiratory distress syndrome (ARDS) is characterized by acute-onset dyspnea, diffuse bilateral pulmonary infiltration, low pulmonary capillary wedge pressure (PCWP), and an arterial oxygen tension/ inspired oxygen fraction (PaO2/FiO2) ratio of less than 200 mmHg. Acute myocardial infarction (AMI), whether complicated by circulatory arrest, cardiogenic shock, and hypotension or not, was reported as an etiologic factor in the development of ARDS in the prethrombolytic era. In the thrombolytic era, two cases of AMI complicated with ARDS have been reported. ARDS in these two patients resulted from anaphylactic reaction to the thrombolytic agent and not from the hemodynamic consequences of AMI. Development of ARDS during the AMI period has not been reported after early successful primary percutaneous coronary intervention (PCI). Herein, we report a 61-year-old male patient with persistent chest pain who was diagnosed with Killip II anterior ST-segment elevation AMI. He was treated successfully with primary PCI 2.5 hours after the onset of chest pain. Unfortunately, on the third hospital day, acuteonset dyspnea (respiratory rate, 33 beats/min), fever (38.5°C), leukocytosis (white blood cell count, 18,360/μL), and diffuse bilateral pulmonary infiltration were noted. ARDS was diagnosed from the low PCWP (8 mmHg) and a PaO2/FiO2 of less than 200 mmHg (160 mmHg). No usual causes of ARDS such as infection, aspiration, trauma, shock, or drug reactions were noted. We assumed that, in this particular patient, the systemic inflammatory response syndrome frequently induced by AMI might have caused this episode of ARDS. This may imply that AMI itself is a possible etiology of ARDS.
Related Links	http://www.sciencedirect.com/science/article/pii/S1607551X09702815
ISSN	1607551X
e-ISSN	24108650
DOI	10.1016/S1607-551X(09)70281-5
Journal	Kaohsiung Journal of Medical Sciences
Issue Number	2
Volume Number	21
Language	English
Publisher	Wiley
Publisher Date	2005-01-01
Publisher Place	Australia
Access Restriction	Open
Subject Keyword	Medicine (general) Acute Respiratory Distress Syndrome Acute Myocardial Infarction Primary Percutaneous Coronary Intervention
Content Type	Text
Resource Type	Article
Subject	Medicine