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Typical patient- Patient with acute myocardial infarction or known left ventricular disease
Major symptoms- Severe dyspnoea and variable circulatory collapse
Major signs- Low-output state (hypotension, oliguria, cold periphery); tachycardia; S3; sweating; crackles at lung bases
Diagnosis- CXR: bilateral air space consolidation with typical perihilar distribution
- Echocardiogram: usually confirms left ventricular disease
Additional investigations- ECG: may show evidence of acute or previous myocardial infarction
- Blood gas analysis: shows variable hypoxaemia
Comments- Although most cases are caused by acute myocardial infarction or advanced left ventricular disease, it is vital to exclude valvular disease or myxoma, which are potentially correctable by surgery.
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