clinical manifestations of pulmonary edema

List and describe the clinical manifestations of pulmonary edema.
Describe the general treatment and management of pulmonary edema

Any damage to the heart caused by disease can result in cardiac (heart) failure. Disorders that can cause cardiac failure include: coronary artery disease, high blood pressure, and diabetes. One of the symptoms associated with cardiac failure is edema. Edema is a term used to describe swelling and is a condition that is characterized by excess fluid that collects in different areas of the body. Approximately 60% of our body weight is composed of water. Body fluid is divided into two major compartments: intracellular fluid and extracellular fluid. Intracellular fluid is fluid found inside the cells of the body. Extracellular fluid is fluid that is found outside of the cells. Extracellular fluid consists of interstitial fluid (fluid between each cell), intravascular fluid (fluid that is found within the blood vessels) and plasma (fluid in the blood stream).

Edema causes puffiness due to fluid that accumulates within tissues. When the right heart fails the result is peripheral or dependent edema, fluid that accumulates in the gravity dependent areas of the body such as feet, ankles, legs and hands. When the left heart fails the result is pulmonary edema, excess fluid that accumulates in the lungs.

Peripheral edema is the result of a weakened right heart that is less efficient at pumping blood from the body to the lungs. Peripheral edema is fluid that builds up in the extremities such as feet, ankles, legs and hands causing swelling due to heart failure. Veins bring deoxygenated blood from the body to the right side of the heart but when the right heart loses its pumping power, blood backs up into the body’s veins causing swelling of the extremities. Pitting edema can be seen in swollen areas by pushing on the affected areas. When the area remains depressed or indented after the release of pressure then pitting edema is present. The treatment for peripheral edema includes diuretics (to remove excess fluid) and inotropic medications (to improve contractility of the heart and the flow of heart).

Pulmonary edema occurs when the left heart weakens and becomes less efficient at pumping blood from the lungs to the body. As less blood flows forward to the body, fluid begins to slowly back up in the lungs resulting in pulmonary congestion referred to as cardiogenic pulmonary edema. Though there are other causes of pulmonary edema, cardiogenic pulmonary edema is caused by increased hydrostatic pressures due to heart failure. Pulmonary edema is fluid that builds up in the interstitial spaces in the lungs. The interstitial spaces in the lungs are the spaces between the alveoli and the capillaries often referred to as the AC membrane. When fluid accumulates in the interstitial spaces it blocks the ability of oxygen to diffuse across the AC membrane resulting in an oxygen defect due to VQ mismatching. The pressure caused by the fluid in the interstitial spaces restricts the alveoli from expanding and will often leak into the alveoli washing the surfactant resulting in atelectasis (collapse of the alveoli). The treatment for pulmonary edema consists of loop diuretics (to remove the excess fluid from the lungs), oxygen (to treat hypoxemia), inotropic medications (to increase the contractility of the heart and improve cardiac ouput) and positive end expiratory pressure, PEEP, (to treat atelectasis and improve VQ mismatch).

Provide detailed responses to the following questions.

Describe the path of blood flow through the heart beginning with the superior and inferior vena cava. (Be sure to list all the heart valves)
Explain at least 2 differences between cor pulmonale and CHF.
What is the etiology of cor pulmonale and of CHF?
Describe in detail the treatment and management of cor pulmonale and CHF.
Submit your answers in at least 500 words on a Word document. You must cite at least three references in APA format to defend and support your position.