Acute Heart Failure With Unilateral Pulmonary Edema Due to Aortic Insufficiency During LVAD Support

Unilateral pulmonary edema (UPE) is a rare manifestation of cardiogenic pulmonary edema that is often confused with other causes of unilateral pulmonary infiltrates. A 47-year-old female with a HeartWare left ventricular assist device (LVAD) presented with dyspnea and UPE. Right heart catheterization revealed inadequate left ventricular unloading in the setting of aortic insufficiency and facilitated LVAD speed adjustment leading to resolution of symptoms. Timely diagnosis of UPE is critical because it is related to an independent increased risk of mortality, likely due to initial misdiagnosis and delayed proper treatment. The increasing use of LVADs in patients with advanced heart failure necessitates a thorough understanding of potential device complications and their management.