Sympathetic Crashing Acute Pulmonary Edema (SCAPE): A Race Against Time in the Emergency Department

Abstract

Sympathetic Crashing Acute Pulmonary Edema (SCAPE) represents the extreme end of the heart failure spectrum, characterised by hemodynamic instability and severe respiratory distress. Prompt recognition and intervention are crucial to reducing morbidity and mortality in patients with SCAPE. High-Dose Nitroglycerin (HDN) and Non-Invasive Ventilation (NIV) are pivotal in managing these cases. We present a case of a 56-year-old man who presented to our Emergency Department (ED) with SCAPE. He was successfully managed with HDN at a dosage of 100 µg/min and positive pressure ventilation. This case underscores the importance of early recognition and aggressive intervention in SCAPE, highlighting the effectiveness of HDN and NIV in stabilising hemodynamics and improving outcomes.