Congestive Heart Failure—Acute Pulmonary Edema

Acute pulmonary edema is a disorder in which L there is sudden and relatively rapid transudation of fluid from the pulmonary capillary bed into the alveolar spaces. Whereas left ventricular failure is the usual cause of acute pulmonary edema, it also occurs after a variety of noncardiac disturbances, such as inhalation of irritating gases, pulmonary embolism, and intracranial hemorrhage. Instances of acute pulmonary edema secondary to disorders of atrial and ventricular rhythm or to mechanical interference with pulmonary venous drainage (mitral stenosis, stenosis of pulmonary veins) represent special conditions. This communication is concerned primarily with pulmonary edema secondary to congestive left ventricular failure.1-3 Mechanism The fundamental disorder in acute pulmonary edema is failure of the left ventricle to serve as an effective pump, due to imbalance between myocardial contractile strength and myocardial load. Such an imbalance is, in turn, related to a loss or damage of myocardial contractile units.