Pulmonary congestion

Introduction Pulmonary congestion refers to the occurrence of blood deposits in the local blood vessels of the lungs, usually caused by left heart failure, increased pressure in the left heart chamber, obstructing pulmonary venous return, causing pulmonary congestion. When the lungs are congested, the lung volume increases and is dark red, and the cut surface flows out of the foamy red bloody liquid. The clinical manifestations of patients with pulmonary congestion are shortness of breath, hypoxia, and cyanosis. When coughing, a large amount of serous pink foam sputum is coughed up.

Cause

Cause

(1) The front load is too heavy.

(2) The afterload is too heavy.

(3) The weakening of myocardial contractility.

(4) The ventricular contraction is not coordinated.

(5) Reduced ventricular compliance.

Predisposing factor

(1) Infection: Viral sensation and pulmonary infection are common causes of heart failure.

(2) Excessive physical labor or emotional excitement.

(3) Arrhythmia.

(4) Pregnancy and childbirth.

(5) Infusion (or transfusion too fast or excessive).

(6) Severe anemia or major bleeding: myocardial ischemia and hypoxia, increased heart rate and increased cardiac load.

an examination

Related inspection

Chest CT examination chest B super chest MRI chest perspective cardiopulmonary exercise test (CPET)

1, ECG: can be found in previous myocardial infarction, left ventricular hypertrophy, extensive myocardial damage and arrhythmia information.

2, chest X-ray: visible heart enlargement, pulmonary congestion, pulmonary edema and information on the original lung disease.

3, echocardiography

(1) Diagnosis of pericardium, myocardial or valvular disease.

(2) Distinguish between diastolic dysfunction and systolic dysfunction.

(3) Quantitative or qualitative indoor diameter, heart geometry, wall thickness, wall motion, and pericardial, valvular and vascular structures, quantitative valve stenosis, degree of insufficiency, measurement of left ventricular ejection fraction (LVEF), left ventricle End-diastolic and end-systolic volume (LVEDV, LVESV).

(4) Estimate pulmonary artery pressure.

(5) Provide objective indicators for evaluating treatment effects.

4, heart failure markers: B-type natriuretic peptide (BNP) and N-terminal B-type natriuretic peptide (NT-proBNP) is a marker of heart failure patients, the value can be reduced after the treatment of symptoms improved.

Differential diagnosis

There are known clinical causes: patients have rest or exertion of dyspnea, physical examination and X-ray examination showed pulmonary congestion, ultrasound showed enlargement of the left atrium, no enlargement of the left ventricle, LVEF>50%. However, the following three conditions must be excluded: left ventricular filling abnormalities caused by mechanical obstruction such as mitral stenosis, left ventricular filling abnormalities caused by pericardial diseases such as constrictive pericarditis, and systolic heart failure (SHF) itself. Abnormal ventricular filling during or with diastolic heart failure (DHF). X-ray examination of cardiopulmonary for diagnostic aid, if necessary, hemodynamic monitoring can be used to confirm the diagnosis.

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