CIBA Foundation Symposium on Pulmonary Structure and Function

By A. V. S. De Reuck; Maeve O'Connor | Go to book overview

PHYSIOLOGICAL AND BIOCHEMICAL EFFECTS OF PULMONARY ARTERY OCCLUSION
JULIUS H. JR. COMROE Cardiovascular Research Institute, University of California Medical Center, San FranciscoTHERE are many curious problems associated with occlusion of a pulmonary artery (Comroe, 1952). For example:
1. Complete occlusion of the right or left pulmonary artery in unanaesthetized man -- by inflating a balloon at the tip of a cardiac catheter -- does not produce pain or discomfort ( Carlens, Hanson and Nordenstroni, 1951; Hanson, 1954), but pulmonary arterial occlusion by embolism usually produces dyspnoca, substernal oppression, pleuritic chest pain, cough and haemoptysis ( Parker and Smith, 1958).
2. Some radiologists have reported that the typical roentgenogram of the chest after pulmonary embolism shows an ischaemic lung ( Westermark, 1954; Shapiro and Rigler, 1948). Others have reported homogeneous densities, particularly in patients with congestive heart failure; these densities are sometimes sharply demarcated or wedge-shaped and often associated with pleural effusion ( Hampton and Castleman, 1940). Still other radiologists ( Steinet al., 1959) have noted a high incidence of elevation of the diaphragm on the side of the embolism; diaphragmatic elevation is usually a sign of atelectasis rather than of pulmonary congestion and haemorrhage.
3. Some radiologists have seen pulmonary densities within 24 hours of the onset of symptoms ( Steinet al., 1959), although others (Short, 1951) have not noted them roentgenographically until after several days.

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