A 48 years old male with presented to the emergency department with chest pain and diagnosed with acute myocardial infarction. Within one hour of presentation he develops pulmonary edema, which responds to intravenous Furosemide. The patient had cardiac angioplasty, and his chest pain resolved within 2 hours of onset. An echocardiogram shows inferior akinesa, EF 50 %, and trivial mitral regurgitation. 10 hours later, recurrent chest pain developes, and the manifestation of acute pulmonary edema return.
On physical examination, he is afebrile, blood pressure 108/64, pulse 102/min, and respiratory rate is 28/min. No jugular venous distention, cardiovascular exam reveals left sterna edge pansystolic murmur radiating to the axilla, lungs, there is rales over lower one-third of lung fields.
Q- Why did episodic pulmonary edema develop in this patient?