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Chronic Pulmonary Edema


Presentation

  • Signs of right ventricular (RV) failure (eg, neck vein distention, peripheral edema) may be present.[merckmanuals.com]
  • Case Presentation A 55-year-old man with a history of congestive heart failure (CHF) and hypertension (HTN) presents with worsening shortness of breath over the last 2 days.[emdocs.net]
  • They are present even in healthy individuals, for whom no treatment is indicated. However, in patients with heart disease, PVCs can be significant indicators of disease processes.[peir.path.uab.edu]
  • Pink, frothy sputum may be present in patients with severe disease. Occasionally, hoarseness may be present as a result of compression of the recurrent laryngeal nerve palsy from an enlarged left atrium, such as in mitral stenosis (Ortner sign).[emedicine.medscape.com]
Weight Gain
  • Gradually appearing symptoms include difficulty breathing while lying in bed, shortness of breath during activity, and weight gain (in patients with congestive heart failure).[icd10data.com]
  • This is characterized by shortness of breath, difficulty breathing, wheezing, the inability to sleep due to coughing or the feeling of breathlessness, fatigue (likely due to the lack of quality rest), swelling in lower extremities, or rapid weight gain[lungmds.com]
  • Common symptoms are dyspnea with exertion, orthopnea (difficulty breathing while lying flat), paroxysmal nocturnal dyspnea (waking up at night severely short of breath), fatigue, leg edema (swelling), and weight gain (due to fluid accumulation).[verywellhealth.com]
  • Typical symptoms include: difficulty breathing when lying flat (orthopnea) swelling (edema) of feet or legs rapid weight gain due to the accumulation of excess fluid paroxysmal nocturnal dyspnea - episodes of severe sudden breathlessness at night fatigue[medicalnewstoday.com]

Treatment

  • Medscape: "Cardiogenic Pulmonary Edema Treatment & Management."[webmd.com]
  • الصفحة 188 - The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. ‏[books.google.com]
  • Treatment is focused on three aspects: firstly improving respiratory function, secondly, treating the underlying cause, and thirdly avoiding further damage to the lung.[icd.codes]
  • Treatment The goal of treatment in cardiogenic flash pulmonary edema includes efforts to maximize heart function by decreasing cardiac work and intravascular volume.[cathlabdigest.com]
  • In these cases, dobutamine is usually first-line treatment.[nps.org.au]

Prognosis

  • Outlook The outlook (prognosis) depends on the cause of the pulmonary oedema. Pulmonary oedema may get better, either quickly or slowly. However, it can also be life-threatening, especially without urgent medical treatment.[patient.info]
  • […] arterial hypoxaemia, and decreased diffusing capacity. 18– 20 Retention of carbon dioxide not previously associated with chronic obstructive pulmonary disease is a common finding in patients presenting with CPO 6, 11, 20– 22 and is associated with a poor prognosis[pmj.bmj.com]
  • What Is the Prognosis for Pulmonary Edema? Cardiogenic pulmonary edema affects up to 2% of the US population and accounts for hundreds of thousands of hospital admissions.[emedicinehealth.com]
  • Long-term prognosis of acute pulmonary oedema--an ominous outcome. Eur J Heart Fail 2000;2:137-44. Messerli FH, Bangalore S, Makani H, Rimoldi SF, Allemann Y, White CJ, et al.[nps.org.au]
  • Further research is needed to clarify whether preventing barrier injury instead of merely controlling hydrostatic pulmonary capillary pressures will improve the treatment and prognosis of AHF. CONFLICTS OF INTEREST None declared.[revespcardiol.org]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • Abstract Electron microscopic studies on the alveolar-capillary barrier were carried out in 13 patients of chronic pulmonary edema and/or congestion resulting from heart disease of various etiologies.[ncbi.nlm.nih.gov]
  • According to the etiology, edema may be localized (in inflammation or in impaired venous drainage) or systemic (in right heart failure or in nephrotic syndrome). A generalized and severe edema is called anasarca.[pathologyatlas.ro]
  • […] manifestations due to the underlying etiology.[icd10data.com]
  • Below we discuss the basic pathogenesis of pulmonary edema along with possible etiologies and then detail the important clinical consequences of this pathology.[pathwaymedicine.org]

Epidemiology

  • Epidemiology The overall incidence rate is reported to be around 10% of cases of pulmonary emboli 4,6. Pathology One of the proposed mechanisms is a redirection of blood to uninvolved areas during occlusion of the pulmonary arterial bed 4.[radiopaedia.org]
  • Epidemiology, pathophysiology, and in-hospital management of pulmonary edema: data from the Romanian Acute Heart Failure Syndromes registry. J Cardiovasc Med (Hagerstown). 2016 Feb. 17(2):92-104. [Medline].[emedicine.medscape.com]
  • The current literature regarding its epidemiology is sparse.[anesthesiology.pubs.asahq.org]
  • Epidemiology of acute heart failure syndromes. Heart Fail Rev. 2007;12:91-5. Medline 6. Cotter G, Metra M, Milo-Cotter O, Dittrich HC, Gheorghiade M.[revespcardiol.org]
Sex distribution
Age distribution

Pathophysiology

  • One method of classifying pulmonary edema is as four main categories on the basis of pathophysiology which include: increased hydrostatic pressure edema two pathophysiological and radiological phases are recognized in the development of pressure edema[radiopaedia.org]
  • In conclusion, pulmonary congestion in AHF is a complex pathophysiologic process, beyond fluid overload and hemodynamics.[revespcardiol.org]
  • The continued central role these drugs play highlights a lack of understanding of the underlying pathophysiology of the disease. Pathophysiology of APE In the 1940s the cardiorenal model was first put forward as the predominant explanation for APE.[emdocs.net]
  • Heart failure: pathophysiology and diagnosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 58. Updated by: Michael A.[medlineplus.gov]
  • The pathophysiology for the formation of pulmonary edema is similar to that of edema formation in the subcutaneous tissues.[tele.med.ru]

Prevention

  • The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000 342, 145-53. ‏[books.google.com]
  • - 0% Emergent - ED Care Needed - Preventable/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 100% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis[codelay.com]
  • Pulmonary edema prevents efficient pulmonary gas exchange in the pulmonary alveoli, and can be life-threatening. Extravascular accumulation of fluid in the pulmonary tissue and air spaces.[icd10data.com]
  • Pneumonia requires immediate treatment to prevent complications, which may require antibiotics and oxygen therapy.[healthline.com]
  • Low levels of BNP ( [2] Prevention [ edit ] In those with underlying heart disease, effective control of congestive symptoms prevents pulmonary edema. [ citation needed ] Dexamethasone is in widespread use for the prevention of high altitude pulmonary[en.wikipedia.org]

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