Acute Leftsided Heart Failure

The pulmonary vascular changes associated with acute left ventricular failure are usually not discernible for two reasons: (1) the resulting severe pulmonary edema obscures the pulmonary vasculature, and (2) the redistribution of PBF secondary to acute left-sided heart failure is usually relatively mild. The combination of alveolar pulmonary edema and a normal-sized heart is the hallmark of acute left-sided heart failure!0 (see BhB; Fig. 12-6,4), most commonly seen in acute myocardial infarction. The edema fluid under this circumstance tends to distribute in a butterfly pattern.27 The reason for this is poorly understood.

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