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Medicine

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Cardiology

Question
11 out of 24
 

Pulmonary edema associated with normal PCWP is observed. Which of these is not a cause: (AIPG 2011)



A High altitude

B Cocaine overdose

C Post cardiopulmonary bypass

D Bilateral renal artery stenosis

Ans. D

Bilateral renal artery stenosis

Note:

1. Left atrial filling pressure closely approximates Pulmonary capillary wedge pressure (PCWP)

2. PCWP is increase in cardiac pulmonary edema but it is normal in non-cardiogenic pulmonary edema

Causes of non-cardiogenic pulmonary edema

1. High altitude

2. Narcotic over dose

3. Burns

4. Smoke inhalation

5. Septicemia

6. Post cardiopulmonary bypass

7. P. falciparum

8. Chest trauma

InvestigationsIf ECG and BNP (Brain natriuretic peptide , are normal, heart failure is unlikely, and an alternative diagnosis should be considered; if either abnormal then echocardiography is required.

CXR Q:

1. Cardiomegaly

2. Classical perihilar 'bat's wing' shadowing Q

3. Pleural effusions

4. Prominent upper lobe veins

5. Kerley B lines Q

ECG may indicate the cause.

Echocardiography is the key investigation may Qindicate the cause (MI, valvular heart disease) and can confirm the presence or absence of LV dysfunction. Ejection fraction is the best parameter to asses LVF.

Cardiology Flashcard List

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