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Myocardial ischemia
Pneumothorax
High-altitude pulmonary edema
Neurogenic pulmonary edema
Pulmonary embolism
Respiratory failure
Pneumothorax
Pneumothorax is defined as the presence of air or gas in the pleural cavity (ie, the potential space
between the visceral and parietal pleura of the lung), which can impair oxygenation and/or ventilation.
The clinical results are dependent on the degree of collapse of the lung on the affected side. If the
pneumothorax is significant, it can cause a shift of the mediastinum and compromise hemodynamic
stability. Air can enter the intrapleural space through a communication from the chest wall (ie, trauma)
or through the lung parenchyma across the visceral pleura.
Pulmonary embolism
Pulmonary emboli usually arise from thrombi that originate in the deep venous system of the lower
extremities; however, they rarely also originate in the pelvic, renal, upper extremity veins, or the right
heart chambers. After traveling to the lung, large thrombi can lodge at the bifurcation of the main
pulmonary artery or the lobar branches and cause hemodynamic compromise.
Pulmonary thromboembolism is not a disease in and of itself. Rather, it is a complication of underlying
venous thrombosis. Under normal conditions, microthrombi (tiny aggregates of red cells, platelets,
and fibrin) are formed and lysed continually within the venous circulatory system.
Myocardial infarction
Myocardial infarction, commonly known as a heart attack, is the irreversible necrosis of heart muscle
secondary to prolonged ischemia. This usually results from an imbalance in oxygen supply and
demand, which is most often caused by plaque rupture with thrombus formation in a coronary vessel,
resulting in an acute reduction of blood supply to a portion of the myocardium.
A low-grade fever, respiratory alkalosis, and leukocytosis are other common features.
In severe cases, an altered mental status, hypotension, and death may result.
Ultrafiltration
Ultrafiltration is a fluid removal procedure that is particularly useful in patients with renal dysfunction
and expected diuretic resistance.
Diet
Patients admitted with heart failure or pulmonary edema should be given a low-salt diet to minimize
fluid retention. Closely monitor their fluid balance.
Inotropic support is usually used following unsuccessful attempts at preload and afterload reduction or
when hypotension precludes the use of these strategies. The 2 main classes of inotropic agents that
are available are catecholamine agents and phosphodiesterase inhibitors (PDIs).