The pathogenesis of acute pulmonary edema associated with hypertension.

  title={The pathogenesis of acute pulmonary edema associated with hypertension.},
  author={Sandeep Gandhi and John C. Powers and A M Nomeir and Karen M. Fowle and Dalane W. Kitzman and Kevin M. Rankin and William C. Little},
  journal={The New England journal of medicine},
  volume={344 1},
BACKGROUND Patients with acute pulmonary edema often have marked hypertension but, after reduction of the blood pressure, have a normal left ventricular ejection fraction (> or =0.50). However, the pulmonary edema may not have resulted from isolated diastolic dysfunction but, instead, may be due to transient systolic dysfunction, acute mitral regurgitation, or both. METHODS We studied 38 patients (14 men and 24 women; mean [+/-SD] age, 67+/-13 years) with acute pulmonary edema and systolic… 

The role of ischemic mitral regurgitation in the pathogenesis of acute pulmonary edema.

In patients with left ventricular systolic dysfunction, acute pulmonary edema is associated with the dynamic changes in ischemic mitral regurgitation and the resulting increase in pulmonary vascular pressure.

Hypertensive acute pulmonary oedema as expression of diastolic heart failure.

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Arterial Hypertension and Flash Pulmonary Edema

  • R. Darabont
  • Medicine, Biology
    Updates in Hypertension and Cardiovascular Protection
  • 2019
Usually, patients presenting with this condition have a long history of uncontrolled arterial hypertension, with left ventricular hypertrophy and preserved ejection fraction, and the clinical evolution is typical for flash pulmonary edema (FPE): sudden and severe flooding of pulmonary alveolar spaces, with rapid recovery after the onset of treatment.

Pathogenesis of pulmonary edema

A new hypothesis is proposed that often the pathogenesis of pulmonary edema is related to a combination of marked increase in systemic vascular resistance superimposed on insufficient systolic and diastolic myocardial functional reserve.

Flash pulmonary edema: association with hypertension and reoccurrence despite coronary revascularization.

Many patients with flash pulmonary edema have preserved systolic left ventricular function and coronary artery disease, suggesting that control of hypertension is important and that coronary revascularization may not be adequate to prevent reoccurrence of flashmonary edema.

The noninvasive assessment of left ventricular diastolic function with two-dimensional and Doppler echocardiography.

Prevalence of heart failure and left ventricular dysfunction in the general population; The Rotterdam Study.

The prevalence of heart failure is appreciable and does not differ between men and women, and the majority of persons with left ventricular systolic dysfunction can be regarded as having asymptomatic left Ventricular syStolic dysfunction.

Diagnosis and treatment of heart failure based on left ventricular systolic or diastolic dysfunction.

A new classification of LV dysfunction has been developed in which patients with LV dysfunction are categorized on the basis of normal or abnormal systolic function, which can be useful in the diagnosis and treatment of individual patients as well as in epidemiologic surveys designed to assess medical practice patterns.

Coronary Hypertension and Diastolic Compliance in Isolated Rabbit Hearts

The correlation between coronary hypertension, decreased left ventricular diastolic compliance, and increased wall thickness in the normal isolated isovolumic blood-perfused rabbit heart suggests that coronary vascular turgor may be a significant factor altering diastsolic compliance of the left ventricle during acute hypertension.

Defining diastolic dysfunction.

As information routinely available to the clinician has been extended from the history and physical examination to now include precise, noninvasive characterization of ventricular volumes and aortic flow, it has been increasingly recognized that the pathophysiology of heart failure cannot be assessed adequately by the older classifications.

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CHF is a disease of the "very elderly," frequently occurs in the setting of normal ejection fraction, and has a poor prognosis, regardless of the level of systolic function.

Defining diastolic heart failure: a call for standardized diagnostic criteria.

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