Acute respiratory failure as primary manifestation of antineutrophil cytoplasmic antibodies-associated vasculitis.

The systemic vasculitides are multifocal diseases characterized by the presence of blood vessel inflammation in multiple organ systems. Their clinical presentation is variable extending from self-limited illness to critical complications including diffuse alveolar hemorrhage and glomerulonephritis. Alveolar hemorrhage is a life-threatening manifestation of pulmonary vasculitis that can rapidly progress into acute respiratory failure requiring ventilatory support.

Chronic thromboembolic pulmonary hypertension: do not miss the chance for an early diagnosis.

Background: Chronic thromboembolic pulmonary hypertension most often results from obstruction of the pulmonary vascular bed by nonresolving thromboemboli. Misdiagnosis of the disease is common because patients often present with subtle or nonspecific symptoms. Furthermore, some features in chest imaging may mimic parenchymal lung disease.

Repeated episodes of respiratory failure due to bilateral vocal cord paralysis.

Background: Bilateral vocal cord paralysis can produce severe airway obstruction, leading to acute respiratory failure. Discriminating the pathology of the upper airway from chronic obstructive diseases of the lower airways often presents a challenge for clinicians in the Emergency Department.

Objectives: To underlie the value of clinical examination and flow-volume loops in the establishment of diagnosis of upper airway obstruction.