UNEXPLAINED PULMONARY-EDEMA - OBSTRUCTION TO PULMONARY VENOUS RETURN DEMONSTRATED BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY - 4 CASE-REPORTS

The usual causes of pulmonary edema are left ventricular dysfunction, mitral valve disease or left atrial myxoma. Obstruction to pulmonary v enous drainage is a rare and unrecognised diagnosis which should be co nsidered when the usual investigations are unproductive. The authors r eport four cases in which transesophageal echocardiography showed pulm onary edema to be due to compression of one or more pulmonary veins by a mediastinal mass (2 cases), by the false lumen of dissection of the aorta (1 case) and postoperative stenosis of the pulmonary veins (1 c ase). These cases underline the diagnostic value of this technique whi ch rapidly provides diagnostic information with privileged visualisati on of the pulmonary veins and abnormalities of acceleration of blood v elocities in the Doppler mode due to obstruction.