Changes in the lungs in heart failure
In acute heart failure the high pressure in pulmonary veins causes a series of pathological changes in the lungs:
- interstitial fluid causes stiffening of the lungs and increases the work of breathing
- oedema of the walls of airways may cause non-asthmatic airways obstruction
- oedema of alveolar walls may impede gaseous exchange
- frank fluid in the alveoli results in gross hypoxaemia and lung crepitations
In the well-diuresed patient with chronic heart failure there are no gross changes in lung structure or function. There may be increased fatiguability of respiratory muscles.
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