Acute Heart Failure and Cardiogenic Pulmonary Edema

Acute Heart Failure and Cardiogenic Pulmonary Edema is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

Acute heart failure (AHF) results from a sudden increase in intracardiac pressure or acute myocardial dysfunction leading to decreased peripheral perfusion and cardiogenic pulmonary edema (CPE). CPE occurs when the pulmonary capillary pressure exceeds the forces that maintain fluid within the vascular space (serum oncotic pressure and interstitial hydrostatic pressure).

  • Increased pulmonary capillary pressure may be caused by LV failure of any cause, obstruction to transmitral flow (e.g., mitral stenosis, atrial myxoma), or rarely, pulmonary veno-occlusive disease.
  • Alveolar flooding and impairment of gas exchange follow accumulation of fluid in the pulmonary interstitium.

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General Principles

Acute heart failure (AHF) results from a sudden increase in intracardiac pressure or acute myocardial dysfunction leading to decreased peripheral perfusion and cardiogenic pulmonary edema (CPE). CPE occurs when the pulmonary capillary pressure exceeds the forces that maintain fluid within the vascular space (serum oncotic pressure and interstitial hydrostatic pressure).

  • Increased pulmonary capillary pressure may be caused by LV failure of any cause, obstruction to transmitral flow (e.g., mitral stenosis, atrial myxoma), or rarely, pulmonary veno-occlusive disease.
  • Alveolar flooding and impairment of gas exchange follow accumulation of fluid in the pulmonary interstitium.

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