What is the role of LV volume overload in the etiology of cardiogenic pulmonary edema (CPE)?

Updated: Jul 23, 2020
  • Author: Ali A Sovari, MD, FACP, FACC; Chief Editor: Gyanendra K Sharma, MD, FACC, FASE  more...
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Answer

LV volume overload occurs in a variety of cardiac or noncardiac conditions. Cardiac conditions are ventricular septal rupture, acute or chronic aortic insufficiency, and acute or chronic mitral regurgitation. Endocarditis, aortic dissection, traumatic rupture, rupture of a congenital valve fenestration, and iatrogenic causes are the most important etiologies of acute aortic regurgitation that may lead to pulmonary edema.

Ventricular septal rupture, aortic insufficiency, and mitral regurgitation cause elevation of LV end-diastolic pressure and LA pressure, leading to pulmonary edema. LV outflow obstruction, such as that caused by aortic stenosis, produces increased end-diastolic filling pressure, increased LA pressure, and increased pulmonary capillary pressures.

Some sodium retention may occur in association with LV systolic dysfunction. However, in certain conditions, such as primary renal disorders, sodium retention and volume overload may play a primary role. CPE can occur in patients with hemodialysis-dependent renal failure, often as a result of noncompliance with dietary restrictions or noncompliance with hemodialysis sessions.


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