Pulmonary Edema Associated With Pulmonary Embolism: a Clinicopathological Study

Yuceoglu, Yusuf Ziya; Rubler, Shirley; Eshwar, K P; Tchertkoff, Victor; Grishman, Arthur

doi:10.1177/000331977102200902

Cited by 16 publications

(4 citation statements)

References 32 publications

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“…Hultgren proposed the perfusion mechanism, which is used to elucidate the hemodynamics of HAPE, which can also be used to explain the occurrence of pulmonary embolism-associated PE. Yuceoglu, who investigated lung embolism-related PE, found that 51% of patients with pulmonary embolism developed PE [ 32 ]. The majority of these patients had a coronary heart disease basis, and those without coronary heart disease had less probability to develop PE.…”

Section: Classification and Mechanism Of Right Heart-related Pulmonar...mentioning

confidence: 99%

Research Progress on the Mechanism of Right Heart-Related Pulmonary Edema

Wang

Zong

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the mechanisms underlying the development of right heart-associated PE. Background. Right heart-related pulmonary edema (PE) refers to PE resulting from impaired right heart function caused by primary or secondary factors, which is common in critically ill patients. Although the clinical manifestations of different types of right heart-related PE are similar, the pathophysiological changes and treatment methods are significantly different. According to the hemodynamic mechanism, right heart-related PE is primarily classified into two types. One is the increase of right heart flow, including extravascular compression, intravascular compression, cardiac compression, and cardiac decompression. The other type is the abnormal distribution of pulmonary circulation, including obstruction, resistance, pleural decompression, or negative pressure. With the development of hemodynamic monitoring, hemodynamic data not only help us understand the specific pathogenesis of right heart-related PE but also assist us in determining the direction of therapy and enabling individualized treatment. Summary. This article presents a review on right heart-associated PE, with a perspective of hemodynamic analysis, and emphasizes the importance of right heart function in the management of circulation. Understanding the mechanism of right heart-associated PE will not only aid in better monitoring right heart function but also help intensivists make a more accurate identification of various types of PE in the clinic.

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Section: Classification and Mechanism Of Right Heart-related Pulmonar...mentioning

confidence: 99%

Research Progress on the Mechanism of Right Heart-Related Pulmonary Edema

Wang

Zong

et al. 2022

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

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“…[1][2][3][4] Indeed, one study in which autopsy examinations were carried out in patients who had died following pulmonary embolism demonstrated an incidence of pulmonary oedema of 24.4% in those patients who had no preceding clinical evidence of cardiac disease. 5 However, if patients with associated cardiac disease were included, the overall incidence of pulmonary oedema was found to be as high as 51%. 5 The mechanism underlying the development of pulmonary oedema secondary to pulmonary embolus is not well understood.…”

Section: Discussionmentioning

confidence: 99%

“…5 However, if patients with associated cardiac disease were included, the overall incidence of pulmonary oedema was found to be as high as 51%. 5 The mechanism underlying the development of pulmonary oedema secondary to pulmonary embolus is not well understood. The size and number of pulmonary emboli seems to bear no relation to the frequency or severity of the subsequent pulmonary oedema 5 ; florid bilateral pulmonary oedema has been seen even in cases of solitary focal pulmonary embolism.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary embolism as a cause of pulmonary oedema

Montgomery

Marshall

Woolf

et al. 1995

Clinical Intensive Care

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Acute pulmonary oedema is a well-described complication of pulmonary embolism. However, the relationship between these two conditions is not widely appreciated by physicians and the diagnosis of an underlying pulmonary embolism in patients with pulmonary oedema may well be missed. We describe two cases in which pulmonary oedema complicated pulmonary embolism, and discuss the possible factors involved in the development of oedema. These include altered left ventricular (LV) function, increased lung microvascular permeability, overperfusion and reperfusion injury. We also emphasise the importance of considering the possibility of an underlying pulmonary embolism in patients with pulmonary oedema so that appropriate thrombolytic therapy can be given early. Case histories Case oneA 78-year-old male ex-smoker with no previous history of cardiorespiratory symptoms presented with a 10-day history of dyspnoea. This had begun six days after a transurethral resection of a bladder tumour when he was awoken by fleeting sharp chest pain, and breathlessness which persisted until admission. On examination he was in sinus rhythm (80 bpm), with an audible third heart sound, a blood pressure of 145/80 mmHg, a jugular venous waveform visible 3 cm above the sternal angle and bilateral pitting oedema up to the lower thigh. Electrocardiography (ECG) showed occasional runs of 10 beats of atrial fibrillation (160 bpm). Arterial blood gases breathing room air were: pH 7.49, PaO 2 10.7 kPa, PaCO 2 4.3 kPa. Plain posteroanterior chest radiography (CXR) showed upper lobe blood diversion and interstitial shadowing. Routine haematology and biochemistry were normal.Left ventricular failure and paroxysmal atrial fibrillation were diagnosed by the admitting junior doctor, and treated with intravenous heparin, diuretics, and amiodarone. Twentyfour hours later the PaO 2 fell to 4.8 kPa (on room air), and the

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“…Permission for a postmortem examination was denied. Discussion Pulmonary oedema is recognized as a complication of pulmonary embolism (Short, 1952;Felson, 1973) but usually occurs in those patients with left ventricular dysfunction (Yuceoglu et al, 1971) and in these individuals is thought to be due to left ventricular failure. Non-cardiogenic pulmonary oedema, or ARDS, occurs in a wide variety of clinical settings such as hypovolaemic shock, major trauma and septicaemia.…”

Section: Introductionmentioning

confidence: 99%