An unusual cause of long-term interstitial pulmonary edema.

A 56-year-old woman was referred for investigation of hibasal interstitial infiltrates on chest x-ray film. The patient gave a six-month history o)f increasing dyspnea on exertion and palpitations. Vital signs included a regular heart rate of 90 beats/mm; blood pressure, 100/70 mm Hg; and respiratory rate, 15/mimi. Cardiovascular exanuination was normal apart from sonic accentuation of the first heart sound, and respirato)ry exammatio)n revealed bihasal fine endinspiratory crepitations. Pulmonary function tests showed a restrictive ventilatory defect with impaired diffusion ca )acity (Table 1). The ECG was normal and the chest x-ray film is shown in Figure 1.