Abstract
A NUMBER OF different patterns of pres entations of ischemic renal disease exist. I These presentations include acute renal failure, often in association with use of an angiotensinconverting enzyme (ACE) inhibitor;2 progressive renal dysfunction in a patient with previously identified renovascular hypertension; progressive renal dysfunction in an elderly patient with refractory hypertension; and unexplained progressive renal dysfunction in an elderly patient. I We describe here three patients with a clinical presentation of long-standing hypertension, renal dysfunction, and episodes of abrupt-onset pulmonary edema that rapidly resolved (flash pulmonary edema) and were out of proportion to the degree of myocardial dysfunction subsequently determined by invasive and/or noninvasive diagnostic testing. These patients underwent successful renal artery bypass grafting without further recurrence of flash pulmonary edema, as well as an improvement in renal function. Flash pulmonary edema constitutes an important new pattern of clinical presentation in patients with renal artery stenosis.
Published Version
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