IPLab:Lab 4:Pulmonary Congestion and Edema
This 69-year-old white male with well-controlled Type I diabetes mellitus (insulin-dependent) presented with upper abdominal and lower chest pain of four hours duration and accompanied by shortness of breathShortness of breath is a common clinical manifestation of heart failure. and diaphoresisDiaphoresis is a profuse perspiration often seen during a myocardial infarction.. An electrocardiogram revealed multiple premature ventricular contractions (PVCs)Premature ventricular contractions (PVCs) are a common cardiac arrhythmia. 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. For example, increased numbers of PVCs are common following an acute myocardial infarction.. The hospital course was characterized by recurrent pulmonary edemaPulmonary edema refers to the accumulation of fluid in the pulmonary alveolar and tissue spaces as a result of changes in capillary permeability and/or increases in capillary hydrostatic pressure. and oliguriaOliguria is the occurrence of decreased urine output.. The terminal event was cardiac arrestCardiac arrest is the sudden standstill of cardiac function..
Significant findings at postmortem examination were old and recent myocardial infarctions and evidence of congestive heart failure. The right and left lungs weighed 950 gramsA normal right lung weighs 450 grams (range: 360 to 570 grams. and 750 gramsA normal left lung weighs 375 grams (range: 325 to 480 grams)., respectively, and were reddish-brown.
Lung: Congestion and Edema
Inflammatory edema has a higher protein content (specific gravity > 1.020) and is associated with an inflammatory reaction.
Noninflammatory edema is caused by alterations in hemodynamic forces across the capillary wall (hemodynamic edema).
- Define the following:
Anasarca: severe and generalized edema which includes marked swelling of the subcutaneous tissues.
Hydrothorax: fluid build-up in the thorax.
Hydropericardium: fluid build-up in the pericardial sac.
Hydroperitoneum: fluid accumulation in the abdominal cavity--also referred to as ascites.
Left-sided heart failure.
- Welch TD, Yang EH, Reeder GS, Gersh BJ. Modern management of acute myocardial infarction. Curr Probl Cardiol 2012 Jul;37(7):237-310.
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