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Pulmonary congestion

disease

Pulmonary congestion refers to blood stasis in local blood vessels of the lung, usually caused by Left heart failure Cause, left Cardiac cavity Internal pressure Elevated, obstructing the lungs Venous reflux , causing pulmonary congestion. When pulmonary congestion occurs, the volume of the lung increases, and it is dark red, and foam red bloody liquid flows out from the section. The clinical manifestations of patients with pulmonary congestion are shortness of breath, hypoxia Cyanosis ， cough When coughing up a lot of serous Pink foam sputum 。 The primary disease causing pulmonary congestion should be actively investigated and treated according to the cause.

TCM disease name

Visiting department

Respiratory Medicine

Common diseases

lungs

Common causes

Caused by left heart failure

common symptom

Shortness of breath hypoxia Cyanosis, coughing up a large amount of serous pink foam sputum

Science popularization in China

Committed to authoritative science communication

The certification expert of this term is

Wei Gengshu | Chief physician

Department of Respiratory Medicine, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine to examine

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essential information

TCM disease name: Pulmonary congestion
Visiting department: Respiratory Medicine
Common location: lungs

Common causes: Caused by left heart failure
common symptom: Shortness of breath hypoxia Cyanosis, coughing up a large amount of serous pink foam sputum

Etiology and common diseases

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one Preload Overweight.

two Afterload Overweight.

three Myocardial contractility Weakening of.

four Ventricular systole uncoordinated 。

five Ventricular compliance Decrease.

6. Common diseases

（1） Mitral insufficiency : fatigue dyspnea 、 Jugular vein distension 、 rale Etc.

（2） Acute left-sided heart failure : convulsions Sitting upright breathing , cyanosis Increased pulmonary blood , pink foam sputum, etc.

(3) Older people Hypertrophic cardiomyopathy : hyperemia, sudden death, upright breathing, fatigue, pulmonary congestion Hepatomegaly Etc.

（4） small cell lung cancer : fatigue pulmonary infection , pulmonary congestion, lymphatic metastasis hemoptysis Etc.

（5） Acute left heart failure in the elderly ： Alar flaring 、 Tidal breathing 、 hypotension , sitting upright and breathing, cyanosis, restlessness Unresponsive 、 Lung rale , pulmonary congestion, pink foam sputum, etc.

（6） Acute postinfectious nephritis in the elderly ： With hypertension 、 proteinuria , nausea, pink foam sputum, etc.

inspect

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1. ECG

Past can be found miocardial infarction 、 Left ventricle Hypertrophy, extensive myocardial damage and Arrhythmia Etc.

2. Chest X-ray film

so Cardiac enlargement , pulmonary congestion, pulmonary edema and original Pulmonary diseases 。

three Echocardiography

(1) Diagnostics pericardium , myocardial or valve disease.

(2) Differentiate between diastolic dysfunction and systolic dysfunction.

(3) Quantitative or qualitative atrioventricular diameter, heart geometry , wall thickness, wall motion, pericardium, valve and vascular structure, quantitative valve stenosis and insufficiency, measurement Left ventricular ejection fraction (LVEF), left ventricle End diastole And end of shrinkage volume (LVEDV, LVESV).

(4) Estimation Pulmonary artery pressure 。

(5) Provide for evaluation of treatment effect Objective indicators 。

4. Heart failure markers

Type B Natriuretic peptide (BNP) and N-terminal pro B-type natriuretic peptide (NT proBNP) are markers of patients with heart failure. After treatment, the value can be reduced.

differential diagnosis

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heart failure The clinical manifestations of the left ventricle or atrium were closely related to the involvement of the left ventricle or atrium. Left heart failure The clinical characteristics of left atrium And/or left ventricular failure Congestion 、 pulmonary edema ； and Right heart failure The clinical characteristics of right atrium And/or right ventricular failure Systemic circulation Venous congestion and Retention of water and sodium 。

1. Left heart failure

(1) Dyspnea: the earliest and most common symptom of left heart failure. Mainly due to acute or chronic pulmonary congestion and vital capacity Caused by reduction. Paroxysmal nocturnal dyspnea It is a manifestation of left heart failure. Patients often wake up in deep sleep, feel suffocated, and are forced to sit up, cough Frequent, with severe dyspnea.

(2) Cough and hemoptysis: common symptoms of left heart failure.

(3) Others: fatigue, insomnia palpitation Etc.

2. Right heart failure

(1) Epigastrium Bulging: It is an early symptom of right heart failure. Often accompanied by Anorexia , nausea, vomiting and upper abdomen Distention pain 。

(2) Jugular vein engorgement: it is an obvious case of right heart failure sign 。

(3) Edema: Heart failure Sexual edema usually occurs first in the lower limbs Sunken edema In severe cases, the whole body may be affected, and the edema of lower limbs may appear or worsen more than in the evening, and may be relieved or disappeared after a night's rest.

(4) Cyanosis: Most patients with right heart failure have different degrees of cyanosis.

(5) nervous system Symptoms: nervousness, insomnia Lethargy And other symptoms.

(6) Cardiac signs: mainly original heart disease Performance.

3. All Heart failure

The clinical manifestations of left and right heart failure can exist at the same time, and the clinical manifestations of left or right heart failure can be the main.

Therapeutic principles

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Find out the primary disease causing pulmonary congestion and treat it according to the cause. hypertension Left ventricle For those with hypertrophy ACEI 、 Calcium channel blocker 、 Beta blocker It can not only reduce blood pressure, but also inhibit and reduce hypertrophic myocardial mass.

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