Circulatory Congestion in Obese Hypertensive Women: A Subset of Pulmonary Edema in Pregnancy
作者:
WILLIAM MABIE,
THOMAS RATTS,
K B RAMANATHAN,
BAHA SIBA,
期刊:
Obstetrics & Gynecology
(OVID Available online 1988)
卷期:
Volume 72,
issue 4
页码: 553-558
ISSN:0029-7844
年代: 1988
出版商: OVID
数据来源: OVID
摘要:
We describe four obese, chronically hypertensive women presenting with antepartum pulmonary edema in whom invasive hemodynamic monitoring showed elevated wedge pressure, normal to high cardiac index, and normal systemic vascular resistance. Echocardiography revealed large chambers, thick walls, and increased left ventricular mass with normal systolic but abnormal diastolic function. These findings are indicative of intrinsic volume overload occurring in the presence of impaired left ventricular relaxation, a combination resulting in high filling pressures and pulmonary congestion. Diuretic therapy is indicated in this subset of patients, who could not be recognized by the usual clinical parameters such as history and physical examination, chest x-ray, and arterial blood gas.
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