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A 64-year-old man with ischemic heart disease was admitted to our hospital because of dyspnea. A chest X-ray film showed a butterfly shadow in the right lung. A chest X-ray film obtained before the patient had respiratory symptoms showed hyperlucency of the left lung. CT scans obtained at maximal inspiration and expiration revealed air trapping. Pulmonary arteriography showed that the left pulmonary artery and its branches were very small. Cardiac catheterization showed poor cardiac function. Swyer-James syndrome should be included in the differential diagnosis of patients with unilateral pulmonary edema.
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