see table on page 239 entered below
comparison of pulmonary vascular disease
pulmonary vascular disease
blood flow in the lungs can be disrupted by a number of disorders that result in occlusion of the vessels and increase pulmonary vascular resistance and destruction of the vascular bed.
obstructs the blood supply to lung parenchyma, occlude pulmonary artery branches. an occlusion of a portion of the pulmonary vascular bed by an embolus, a thrombus (blood clot), tissue fragment, fat, or air bubble. mostly from deep veins in the thigh or leg... venous thromboembolism.
mean pulmonary artery pressure 5 to 10 mmHg above normal or above 20 mmHg.....(it is normally 15 to 18)... classified as 1. pulmonary arterial hypertension, 2. pulmonary venous hypertension 3. pulmonary hypertension from disease of respiratory system 4. pulmonary hypertension from chronic thrombotic and embolic disease 5. pulmonary hypertension from disorders affecting the pulmonary vasculature... shows enlarged pulmonary artery, involves deep vein thrombosis, shows right ventircular hypertrophy
pulmonary heart disease, right heart failure, consists of right ventricular enlargement (hypertrophy, dilation or both). it is secondary to pulmonary hypertension and caused by disorders of the lungs and chest wall. from overloaded right ventricle from pulmonary hypertension....manifested by altered tircuspid and pulmonic valve sounds.
Blood borne substances from venous stasis, endothelial vessel injury, or hypercoagulation lodge in a branch of the pulmonary artery and obstruct blood flow. released neurohumoral substances cause widespread vasoconstriction, further impeding blood flow to the lungs.
earlier evidence of deep vein thrombosis of legs or pelvis, tachypnea, dyspnea, chest pain, hypotension, shock, possible radiographic wedge shape bordering the pleura
avoid venous stasis, anticoagulant therapy, fibrinolytic agent if life threatening.
pulmonary arterial pressure is elevated by increased left ventricular pressure, increased blood flow through the pulmonary circulation, obliteration or obstruction of the vascular bed produced by hypoxemia or acidosis, secondary to lung disease
fatigue, chest discomfort, tachypnea, dyspnea with exercise, a radiograph or electrocardiogram that shows right ventricular hypertrophy
supplemental oxygen, vasodilators, endothelin antagonist, and nitric oxides are palliative, lung transplant is theraputic.
cor pumonale cause
pulmonary hypertension caused by disorders of the lungs or chest wall, leads to right ventricular enlargement.
cor pulmonale manifestations
same as hypertension