Pulmonary edema due to obstructive sleep apnea.

Many cardiorespiratory problems have been identified in patients with sleep apnea syndrome. Acute pulmonary edema as the primary feature of obstructive sleep apnea has recently been reported, and is thought to be caused by the effects of severe hypoxemia and/or extreme negative intrathoracic pressure. We have described another patient with sleep apnea syndrome who had pulmonary edema on at least three different occasions. Extremely high pulmonary artery pressure, paradoxic motion of the interventricular septum, and very low right heart ejection fraction were found. The paradoxic septal motion disappeared and the right heart ejection fraction increased after tracheostomy.