Post-obstruction pulmonary edema complicated by transient cardiac dysfunction in a young woman

A 17-year-old woman who had been healthy since birth developed postobstruction pulmonary edema (POPE) after maxillofacial surgery. She was extubated in a semi-conscious state after general anesthesia, and developed severe airway obstruction due to glossoptosis, and blood and secretions in the oral cavity. When the obstruction was released approximately 10 min later, the chest radiograph showed an increased cardiothoracic ratio, and cardiac ultrasonography showed a reduction in the left ventricular ejection fraction when compared to the normal values for the same age. A diagnosis of type-I POPE with associated left ventricular dysfunction was made, and oxygen and diuretic administration were initiated. When continued hypoxemia is found, even after the elimination of any airway obstruction, it is important to evaluate left cardiac function, with due consideration to the possibility of POPE.