Negative-pressure pulmonary oedema following choking on a rice ball

Description

A 74-year-old woman was brought to the emergency department by ambulance due to choking. Thirty minutes prior to presentation, the patient choked on a rice ball at lunch, and repeated banging on her back by family members led to successful dislodgement of a part of the object. The patient had a history of depression but no history of smoking.

On arrival, she was cyanotic and in respiratory distress. On physical examination, the patient was afebrile, with a heart rate of 112 beats per minute, blood pressure of 142/93 mm Hg, respiratory rate of 26 breaths per minute and oxygen saturation of 93% on 10 L/min via face mask. Her body mass index was 27 (64 kg for 1.53 m). Significant physical examination findings included inspiratory crackles in the right upper zone without wheezing, regular heart sounds without murmur or gallop, and no oedema.

A 12-lead ECG showed normal sinus rhythm with...

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