Chest
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Hypereosinophilic syndrome (HES) is an infiltrative disease of eosinophils affecting multiple organs, including the lung. Hypereosinophilic syndrome differs from acute and chronic eosinophilic pneumonia clinically and usually necessitates treatment with alkylating agents and/or corticosteroids. ⋯ One of our patients developed the adult respiratory distress syndrome thought to be a complication of the HES. Aggressive treatment of HES in both cases combined with intensive support in the patient with ARDS resulted in prolonged survival.
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Shortness of breath after pneumonectomy is a common finding that has multiple causes. We report the cases of two patients with shortness of breath on assuming an upright posture (platypnea) that followed pneumonectomy; these individuals developed right-to-left shunt across a patent foramen ovale (PFO) with normal right-sided intracardiac pressures. Both contrast echocardiography and magnetic resonance imaging (MRI), including a recently introduced dynamic ultrafast imaging technique, proved helpful in diagnosing this condition noninvasively.