CTICasesAsymmetric Pulmonary Edema from Eccentric Mitral Regurgitation
Imaging findings
Chest radiograph shows diffuse interstitial edema that is right greater than left. Subsequent CT pulmonary angiogram, performed to evaluate for pulmonary embolism, again shows diffuse interstitial edema and pleural fluid, along with small nodules in the lower lungs that represent septal lakes of interstitial edema rather than a separate parenchymal nodular process.
Key takeaways
Echocardiography showed mitral valve prolapse with regurgitation, and transesophageal echocardiography confirmed substantial abnormality of the mitral valve with a bulging leaflet and a significant eccentric regurgitant jet. The asymmetric, right-predominant pulmonary edema is explained by the direction of this eccentric mitral regurgitant jet, a classic but under-recognized mechanism for unilateral or asymmetric pulmonary edema.
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