Flash Pulmonary Edema Triggered by Tadalafil Use in a Patient With Chronic Left Bundle Branch Block.

This case report discusses the diagnosis and management of flash pulmonary edema (FPE) in a 61-year-old male patient with a history of uncontrolled hypertension, type 2 diabetes, dyslipidemia, erectile dysfunction, and chronic complete left bundle branch block. The patient presented with acute respiratory distress two hours after tadalafil use. Evaluation revealed hypoxemia and diffuse pulmonary edema, with echocardiography revealing normal systolic function and tissue Doppler imaging suggesting grade I diastolic dysfunction. The patient's symptoms resolved with oxygen, diuresis, and discontinuation of tadalafil. This case emphasizes the need for caution when prescribing phosphodiesterase type 5 inhibitors such as tadalafil to patients with structural or conduction cardiac abnormalities and the importance of prompt recognition and management of FPE in this population.