Pulmonary Oedema Flashcards
What are the 4 main causes of pulmonary oedema?
Increased Left Atrial pressure
Increased pre load
Decreased oncotic pressure
Increased pulmonary vessel permeability
What causes increased preload of blood flowing to the pulmonary circulation?
Iatrogenic giving too much fluids to a patient
When the body is in stress what hormone is released leading to water retention to try and increase the blood pressure?
ADH
What causes oncotic pressure to reduce leading to pulmonary oedema?
Decreased levels of albumin
What causes increased permeability to the pulmonary vessels leading to pulmonary oedema?
Release of cytokines from Inflammatory processes like infections (pneumonia)
What causes increased permeability to the pulmonary vessels leading to pulmonary oedema?
Release of cytokines from Inflammatory processes like infections (pneumonia)
What are the categories that the 10 causes of increased left atrial pressure that cause pulmonary oedema can be put in?
Left ventricular failures
Arryhthmias
Valvular disease
Restrictive cardiomyopathies
HTN
Endocrine issues
What is the most common cause of pulmonary oedema due to increased left atrial pressure?
Left Ventricular Diastolic Failure (LVDF)
What are the 2 types of left ventricular failure that can cause increased Left Atrial pressure leading to pulmonary oedema?
Left Ventricular Diastolic Failure (HFpEF)
Left Ventricular Systolic Failure (HFrEF)
What is the pathophysiology of left ventricular diastolic dysfunction (HFpEF)?
Ventricle has become stiff/non compliant so its filling in diastole is impaired
What arrhythmia causes increased Left Atrial pressure leading to pulmonary oedema?
Atrial fibrillation (AF)
What are the 3 reasons that atrial fibrillation (AF) causes increased left atrial pressure leading to pulmonary oedema?
Reduced diastolic emptying due to less time in diastole with the HR being faster
Loss of atrial systole
Irregular blood flow
What are the 3 causes of Left Ventricular Systolic Failure (HFrEF) leading to increased left atrial pressure causing pulmonary oedema?
Myocardial infarction
Myocardial ischaemia
Myocarditis
What are the valvular diseases that can cause increased left atrial pressure leading to pulmonary oedema?
Aortic stenosis
Aortic regurgitation
Mitral regurgitation
Mitral stenosis
What are some causes of mitral regurgitation that can increase left atrial pressure leading to pulmonary oedema?
Infective endocarditis
Rheumatic heart disease
Myocardial infarction
Acute chordae tendineae rupture
What are the 2 ways a Myocardial infarction cause mitral regurgitation which can increase left atrial pressure leading to pulmonary oedema?
Anterior infarction (LAD) damages papillary muscles which hold thee ANTERIOR leaflet preventing it from being pushed too far open
Circumflex infarction means posterior leaflet stays open
Why can a pregnant woman not be allowed tot give birth if she has severe mitral stenosis?
As soon as given birth, clamping down on the placenta leads to all of its fluid returning back into circulation rapidly causing rapid increase in Left atrial pressure leading to arrhythmia, acute pulmonary oedema and cardiac arrest
What can cause a dynamic mitral stenosis?
Atrial Myxoma
What can cause mitral stenosis?
Rheumatic fever
Age related calcification
Infective endocarditis
Rheumatoid or SLE
What can cause aortic regurgitation that leads to increase left atrial pressure leading to pulmonary oedema?
Type A aortic dissection
Infective endocarditis
What is a type A aortic dissection?
Any part of the ascending aorta is ruptured or the aortic arch is ruptured
How does hypertension lead to increase left atrial pressure leading to pulmonary oedema?
Increased pre load in the left ventricle leads to ventricular stiffness and remodellingi
How do patients present with Malignant Hypertension/ how is it diagnosed?
SBP > 180 DBP > 120
Present with at least 1 of:
-papilloedma
-pulmonary oedema
-stroke
What are the 3 endocrine disorders which can increase left atrial pressure leading to pulmonary oedema?
Cushing’s
Conns syndrome
Phaeochromocytoma