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IPLab:Lab 4:Pulmonary Congestion and Edema

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Contents

Clinical SummaryEdit

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 breath and diaphoresis. An electrocardiogram revealed multiple premature ventricular contractions (PVCs). The hospital course was characterized by recurrent pulmonary edema and oliguria. The terminal event was cardiac arrest.

Autopsy FindingsEdit

Significant findings at postmortem examination were old and recent myocardial infarctions and evidence of congestive heart failure. The right and left lungs weighed 950 grams and 750 grams, respectively, and were reddish-brown.

ImagesEdit

Study QuestionsEdit

  • Define the following:


Shortness of breath is a common clinical manifestation of heart failure.

Diaphoresis is a profuse perspiration often seen during a myocardial infarction.

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.

Pulmonary 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.

Oliguria is the occurrence of decreased urine output.

Cardiac arrest is the sudden standstill of cardiac function.

A normal right lung weighs 450 grams (range: 360 to 570 grams.

A normal left lung weighs 375 grams (range: 325 to 480 grams).

Pulmonary congestion is the engorgement of pulmonary vessels with blood. The increased pressure caused by this engorgement leads to transudation of fluid through the capillary walls and into the alveolar and interstitial spaces.