Sponge Lung: Pulmonary edema superimposed on emphysema
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A 54-year-old male with a known history of emphysema, coronary artery disease, and congestive heart failure presented with chest pain and shortness of breath of three days’ duration. A physical exam is positive for increased work of breathing, diffuse crackles most prominent at the bases, and overall decreased breath sounds. The patient was afebrile with a normal white blood cell count. He was admitted and treatment begun for COPD exacerbation. Shortly after admission, the patient had rapid desaturation requiring treatment with a non-rebreather mask. Imaging was obtained for further evaluation. The patient’s B-type Natriuretic Peptide (BNP) was 697 which indicate moderate heart failure.

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