A Rare Case Report of Contrast Media-induced Sympathetic Crashing Acute Pulmonary Edema
Introduction: Sympathetic crashing acute pulmonary edema (SCAPE), also known as flash pulmonary edema or hypertensive acute heart failure, is a critical condition characterized by a rapid escalation of sympathetic outflow, excessive afterload, and worsening heart failure. Although rare, contrast med...
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eScholarship Publishing, University of California
2025-05-01
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| Series: | Clinical Practice and Cases in Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/0n68h8d3 |
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| author | Clates P. Adams Christian I Wade |
| author_facet | Clates P. Adams Christian I Wade |
| author_sort | Clates P. Adams |
| collection | DOAJ |
| description | Introduction: Sympathetic crashing acute pulmonary edema (SCAPE), also known as flash pulmonary edema or hypertensive acute heart failure, is a critical condition characterized by a rapid escalation of sympathetic outflow, excessive afterload, and worsening heart failure. Although rare, contrast media-induced pulmonary edema is a severe adverse reaction, occurring in 0.001–0.008% of patients receiving intravenous contrast and accounting for 10–20% of lethal contrast reactions. Case Report: A 70-year-old male developed acute respiratory distress shortly after undergoing an outpatient, contrast-enhanced computed tomography. Despite treatment for suspected anaphylaxis, the patient’s condition continued to deteriorate until a diagnosis of SCAPE was ultimately recognized. Treatment with high-dose nitroglycerin, non-invasive positive pressure ventilation (NIPPV), and eventual intubation resulted in the patient’s full recovery. Conclusion: This report highlights the importance of recognizing SCAPE in patients presenting with sudden dyspnea after contrast administration and emphasizes the need for early intervention with NIPPV and vasodilators to reduce morbidity and mortality. |
| format | Article |
| id | doaj-art-ff25b998c4cf4785a21151a97f97f30c |
| institution | Kabale University |
| issn | 2474-252X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Clinical Practice and Cases in Emergency Medicine |
| spelling | doaj-art-ff25b998c4cf4785a21151a97f97f30c2025-08-20T04:02:41ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2025-05-019328228410.5811/cpcem.38444cpcem-9-282A Rare Case Report of Contrast Media-induced Sympathetic Crashing Acute Pulmonary EdemaClates P. Adams0Christian I Wade1Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, WashingtonBrooke Army Medical Center, The San Antonio Uniformed Service Health Education Consortium, Department of Emergency Medicine, San Antonio, TexasIntroduction: Sympathetic crashing acute pulmonary edema (SCAPE), also known as flash pulmonary edema or hypertensive acute heart failure, is a critical condition characterized by a rapid escalation of sympathetic outflow, excessive afterload, and worsening heart failure. Although rare, contrast media-induced pulmonary edema is a severe adverse reaction, occurring in 0.001–0.008% of patients receiving intravenous contrast and accounting for 10–20% of lethal contrast reactions. Case Report: A 70-year-old male developed acute respiratory distress shortly after undergoing an outpatient, contrast-enhanced computed tomography. Despite treatment for suspected anaphylaxis, the patient’s condition continued to deteriorate until a diagnosis of SCAPE was ultimately recognized. Treatment with high-dose nitroglycerin, non-invasive positive pressure ventilation (NIPPV), and eventual intubation resulted in the patient’s full recovery. Conclusion: This report highlights the importance of recognizing SCAPE in patients presenting with sudden dyspnea after contrast administration and emphasizes the need for early intervention with NIPPV and vasodilators to reduce morbidity and mortality.https://escholarship.org/uc/item/0n68h8d3 |
| spellingShingle | Clates P. Adams Christian I Wade A Rare Case Report of Contrast Media-induced Sympathetic Crashing Acute Pulmonary Edema Clinical Practice and Cases in Emergency Medicine |
| title | A Rare Case Report of Contrast Media-induced Sympathetic Crashing Acute Pulmonary Edema |
| title_full | A Rare Case Report of Contrast Media-induced Sympathetic Crashing Acute Pulmonary Edema |
| title_fullStr | A Rare Case Report of Contrast Media-induced Sympathetic Crashing Acute Pulmonary Edema |
| title_full_unstemmed | A Rare Case Report of Contrast Media-induced Sympathetic Crashing Acute Pulmonary Edema |
| title_short | A Rare Case Report of Contrast Media-induced Sympathetic Crashing Acute Pulmonary Edema |
| title_sort | rare case report of contrast media induced sympathetic crashing acute pulmonary edema |
| url | https://escholarship.org/uc/item/0n68h8d3 |
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