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Monday, 25 November 2013

Pulmonary vascular disease: Pulmonary edema- The Complications

Pulmonary vascular disease is defined as a condition of blood flow to the lung’s artery is blocked suddenly due to a blood clot somewhere in the body, including pulmonary embolism, chronic thromboembolic disease, pulmonary arterial hypertension, pulmonary veno-occlusive disease, pulmonary arteriovenous malformations, pulmonary edema, etc.
Pulmonary edema
Pulmonary edema is defined as a condition of fluid accumulation in the air spaces and parenchyma of the lungs of that can lead to difficult of breathing and respiratory failure.
A. Complications
1. Acute heart attack (myocardial infarction [MI])
According to the article by American medical network, typical causes of acute cardiogenic pulmonary edema include acute myocardial infarction or severe ischemia, exacerbation of chronic heart failure, acute volume overload of the left ventricle (valvular regurgitation), and mitral stenosis(11).
2. Cardiogenic shock
According to the study to identify the independent predictors of 30-day mortality and to analyse the outcomes of patients with cardiogenic shock (CS) associated with acute myocardial infarction (AMI) and necessitating extracorporeal life support (ECLS), of a total 77 patients who had required ECLS support for AMI with CS, Pulmonary oedema occurred in 24 patients (31.6%)(12).
3. Arrhythmias
In Thirty cases (23 males) of post cardioversion acute pulmonary edema identified with the mean age was 53.8 +/- 13 years (range, 18 to 75 years), underlying arrhythmias were atrial fibrillation (69%), atrial flutter (24%), supraventricular tachycardia (4%), and ventricular tachycardia (4%). The duration of arrhythmia preceding cardioversion varied widely ranging from 1 day to 13 years, according to Beth Israel Medical Cente(13).
4. Electrolyte disturbances
According to the article of Fluid and Electrolyte Regulation by Kathryn E.Roberts, respiratory system examination includes an assessment of thepatient’s respiratory effort, an increaseor decrease in respiratory rate and depth, and work of breathing.The presence of rales on auscultation, indicating fluid volume excess, is observed(14).
5. Protein enteropathyIn the differential diagnosis, protein-losing enteropathy (PLE) is a rarely considered explanation of edema. Three such cases are reported in this the study by the Kaohsiung Medical University(15).
6. Death.

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Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/19739476
(11) http://www.health.am/cardio/more/acute_heart_failure_pulmonary_edema/
(12) http://www.ncbi.nlm.nih.gov/pubmed/23616484
(13) http://www.ncbi.nlm.nih.gov/pubmed/14659864
(14) http://repository.upenn.edu/cgi/viewcontent.cgi?filename=10&article=1003&context=miscellaneous_papers&type=additional
(15) http://www.ncbi.nlm.nih.gov/pubmed/12036201