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{
    "pk": 38444,
    "title": "A Rare Case Report of Contrast Media-induced Sympathetic Crashing Acute Pulmonary Edema",
    "subtitle": null,
    "abstract": "<p><strong>Introduction</strong>: 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<br>media-induced pulmonary edema is a severe adverse reaction, occurring in 0.001-0.008% of patients<br>receiving intravenous contrast and accounting for 10-20% of lethal contrast reactions.</p>\n<p><strong>Case Report:</strong> 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.</p>\n<p><strong>Conclusion: </strong>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.</p>",
    "language": "eng",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "SCAPE"
        },
        {
            "word": "pulmonary edema"
        },
        {
            "word": "hypoxia"
        },
        {
            "word": "contrast induced"
        },
        {
            "word": "case report"
        }
    ],
    "section": "Case Reports",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/0n68h8d3",
    "frozenauthors": [
        {
            "first_name": "Clates",
            "middle_name": "P",
            "last_name": "Adams",
            "name_suffix": "",
            "institution": "Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, Washington",
            "department": ""
        },
        {
            "first_name": "Christian",
            "middle_name": "I",
            "last_name": "Wade",
            "name_suffix": "",
            "institution": "Brooke Army Medical Center, The San Antonio Uniformed Service Health Education Consortium, Department of Emergency Medicine, San Antonio, Texas",
            "department": ""
        }
    ],
    "date_submitted": "2024-10-28T06:33:16.454000+08:00",
    "date_accepted": "2025-02-20T03:14:44.887000+08:00",
    "date_published": "2025-05-07T01:44:00+08:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "PDF",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/38444/galley/38477/download/"
        }
    ]
}