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Old 09-22-2011
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Lungs PCWP in Lung Disorders

What happen to PCWP in pulmonary hypertension and pulmonary edema and pulmonary embolism?

How to differentiate these conditions?
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Old 09-22-2011
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Pulmonary capillary wedge pressure (PCWP) provides an indirect estimate of left atrial pressure (LAP). It is helpful to measure PCWP to diagnose the severity of left ventricular failure and to quantify the degree of mitral valve stenosis. Both of these conditions elevate LAP and therefore PCWP. Aortic valve stenosis and regurgitation, and mitral regurgitation also elevate LAP.
PCWP increases in:
Intravascular volume over load, cardiac tamponade, restrictive cardiomyopathy, LV dysfunction (MS/ insufficiency, aortic stenosis/insufficiency & diminished LV compliance (ischemia, fibrosis & hypertrophy). The only clinically significant reason for a decrease PCWP is hypovolemia.
PCWP is usually normal in pulmonary embolism.
When PCWP pressures are above 20 mmHg, pulmonary edema is likely to be present, which is a life-threatening condition.
PCWP is also important to measure when evaluating pulmonary hypertension. Pulmonary hypertension can result from increases in pulmonary venous pressure and pulmonary blood volume secondary to left ventricular failure or mitral or aortic valve disease, so PCWP can be increased in pulmonary hypertension.
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why pcwp is normal in pulmonary embolism? If emboli blocking vessel means it should increase back volume so pressure should increase and rt ventricle pressure increases right?
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Old 09-22-2011
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As I've said pulmonary capillary wedge pressure (PCWP) provides an indirect estimate of left atrial pressure (LAP)& It is helpful to measure the severity of left ventricular failure and to quantify the degree of mitral valve stenosis, and as you can see PE has no significant direct effects on those parameters. PE affects the RT side of the heart.
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Quote:
Originally Posted by ag2011n View Post
Pulmonary capillary wedge pressure (PCWP) provides an indirect estimate of left atrial pressure (LAP). It is helpful to measure PCWP to diagnose the severity of left ventricular failure and to quantify the degree of mitral valve stenosis. Both of these conditions elevate LAP and therefore PCWP. Aortic valve stenosis and regurgitation, and mitral regurgitation also elevate LAP.
PCWP increases in:
Intravascular volume over load, cardiac tamponade, restrictive cardiomyopathy, LV dysfunction (MS/ insufficiency, aortic stenosis/insufficiency & diminished LV compliance (ischemia, fibrosis & hypertrophy). The only clinically significant reason for a decrease PCWP is hypovolemia.
PCWP is usually normal in pulmonary embolism.
When PCWP pressures are above 20 mmHg, pulmonary edema is likely to be present, which is a life-threatening condition.
PCWP is also important to measure when evaluating pulmonary hypertension. Pulmonary hypertension can result from increases in pulmonary venous pressure and pulmonary blood volume secondary to left ventricular failure or mitral or aortic valve disease, so PCWP can be increased in pulmonary hypertension.

thanks...well explained
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Old 09-22-2011
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and I would like to add that PCWP is normal in idiopathic pulmonary hypertension., and high only if its secondary to left ventricular failure.
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Old 04-24-2014
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PCWP also raised in myocardial contusions
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