Monday, June 26, 2017

What is Pulmonary Oedema –



What is Pulmonary Oedema
Pulmonary edema is fluid accumulation in the tissue and air spaces of the lungs leading to impaired gas exchange which may cause respiratory failure.
It is due to either failure of the left ventricle of the heart to remove blood adequately from the pulmonary circulation (cardiogenic pulmonary edema), or an injury to the lung parenchyma or vasculature of the lung (noncardiogenic pulmonary edema).
Discussion
The most common symptom of pulmonary edema is presents with difficulty in breathing, but may include other symptoms such as coughing up blood ( seen as pink, frothy sputum), excessive sweating, anxiety, and pale skin, orthopnea (inability to lie down flat due to breathlessness) and/or paroxysmal nocturnal dyspnea (episodes of severe sudden breathlessness at night).
These are common presenting symptoms of chronic pulmonary edema due to left ventricular failure. The development of pulmonary edema may be associated with symptoms and signs of "fluid overload"; this is a non-specific term to describe the manifestations of left ventricular failure on the rest of the body and includes peripheral edema (swelling of the legs, in general, of the "pitting" variety, wherein the skin is slow to return to normal when pressed upon), raised jugular venous pressure and hepatomegaly, where the liver is enlarged and may be tender or even pulsatile. Other signs include end-inspiratory crackles (sounds heard at the end of a deep breath) on auscultation and the presence of a third heart sound.
As, the prakruti shift towards parthiv which is else parthivo jalaja. The tissue becomes hygroscopic and also finds a lot of akash element providing space for jal accumulation as fibrosis ensues. The lung tissue which retains water possibly due to impaired drainage across the capillary channels and hygroscopic character which consequently results in oedema. The important point to be noted is –
Loss of heat symbolic of reduced pitta and also shows up in reduced drainage as along with it pulmonary dosha balance is symbolic of a dried state which is shown up as fibrosed tissue. We must remember that as the heart is cycles the blood with each pulse, the same cycles across the pulmonary channels. This shift reduces the pulmonary partial pressure and affects exchanges and also increases cardiac load which in turn leads to pulmonary oedema in a cyclic change.
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