THOMAS J. MCHUGH, M.D., F.A.C.P.; JAMES S. FORRESTER, M.D.; LOUIS ADLER, M.D.; DAVID ZION, M.D.; H. J. C. SWAN, M.D., Ph.D., F.A.C.P.
Simultaneous chest X ray, pulmonary capillary wedge pressure, and pulmonary artery oxygen saturation measurements were obtained in 30 patients with acute myocardial infarction. The severity of radiologic abnormalities generally correlated well with pulmonary capillary wedge pressure. Serious misinterpretation of left ventricular failure by X-ray criteria, although uncommon, occurred in the presence of "preclinical" failure, hypoxemia, or posttherapeutic phase-lags. Individual radiologic criteria of left ventricular failure appeared in a predictable sequence. Redistribution of flow appeared early, followed by loss of the sharp marginal contour of the pulmonary vessels, development of perihilar haze, and, finally, periacinar rosette formation. Thus, radiologic criteria of the degree of pulmonary vascular congestion, when related to pulmonary capillary wedge measurements, provide a basis for consistent and rational therapy of left ventricular failure secondary to acute myocardial infarction.
MCHUGH TJ, FORRESTER JS, ADLER L, ZION D, SWAN HJC. Pulmonary Vascular Congestion in Acute Myocardial Infarction: Hemodynamic and Radiologic Correlations. Ann Intern Med. ;76:29–33. doi: 10.7326/0003-4819-76-1-29
Download citation file:
Published: Ann Intern Med. 1972;76(1):29-33.
Acute Coronary Syndromes, Cardiology, Coronary Heart Disease, Emergency Medicine, Pulmonary/Critical Care.
Results provided by:
Copyright © 2019 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use