Pulmonary Oedema

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The main cause of pulmonary oedema is pulmonary capillary congestion due to left ventricular failure
Pulmonary oedema is due to an increase of fluid in alveolar walls (pulmonary interstitium)
which, if severe, subsequently affects alveolar spaces.
The main cause of pulmonary oedema is failure of the left ventricle, causing increased pressure in the alveolar capillaries.
Fluid leaks from capillaries into the pulmonary interstitium, and there is increase in flow of
fluid into pulmonary lymphatics.
This increases the stiffness of the lungs, giving rise to a subjective sensation of dyspnoea. Such a condition may remain stable for a long period of time.
In severe left ventricular failure, fluid also leaks into alveolar spaces, resulting in severe
acute impairment of respiratory function.
Capillary rupture leads to leakage of red cells into the interstitium, as well as into alveoli.
Haemoglobin is phagocytosed by macrophages, which accumulate iron pigment and lie in alveoli and
interstitium. They are often termed 'heart-failure cells'.
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