Left Heart Failure – Pulmonary Edema, Paroxysmal Nocturnal Dyspnea & Orthopnea

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Page 273: Left Heart Failure

What is the reason for pulmonary edema as well as  paroxysmal nocturnal dyspnea to happen in a patient with left sided heart failure?

The reason this would happen is because in left sided heart failure there would be an increase in pulmonary venous pressure, so the blood that’s coming to the heart from the lungs, there will be an increase in pressure in that blood. And because of this there will be pulmonary venous distention, and because of this, it leads to transudation of fluid.

And all this fluid backs up into the lungs, and therefore you’ll have pulmonary edema and paroxysmal nocturnal dyspnea.

What are some of the cells that you would also find in the lungs of a patient with left sided heart failure? In a patient with left sided heart failure you would find hemosiderin laden macrophages which are known as the heart failure cells, and these would be present in the lungs.

Why does orthopnea happen in Left sided heart failure? In left sided heart failure, the reason you would have orthopnea, is because there would be an increase in venous return in supine position which will exacerbate pulmonary vascular congestion.

What is orthopnea? Orthopnea is a condition where there’s a shortness of breath while the person is in supine position, so they can only breathe comfortably when they’re standing or sitting erect.
Left Heart Failure - Pulmonary Edema, Paroxysmal Nocturnal Dyspnea & Orthopnea

 
 
 

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