Advertisement

Kardiologie pp 723-738 | Cite as

Pulmonal verursachte Herzerkrankungen

  • Maurice Sokolow
  • Malcolm B. Mcllroy

Zusammenfassung

Das Herz wird über die Lungen hauptsächlich durch Veränderungen des pulmonalen Gefäßbetts mitgeschädigt. Dabei bestehen gegenseitige Wechselwirkungen. Einerseits können Herzkrankheiten die Lungengefäße (Venen, Kapillaren, Arteriolen) beeinträchtigen und dadurch eine Schädigung des Lungenparenchyms auslösen, andererseits wirken Erkrankungen des Lungenparenchyms ebenfalls auf die Lungengefäße und somit auch auf das Herz, wobei hauptsächlich der rechte Ventrikel betroffen ist. Die pulmonalen Gefäße können selbst primärer Sitz der Erkrankung sein. Beispiele sind: Schistosomiasis (Bilharziose), primäre pulmonale Hypertonie, pulmonale Arteriovenöse Fistel und Lungenembolie. Die Auswirkungen von Lungenembolien hängen entscheidend von einer gleichzeitig bestehenden Herzerkrankung ab. Die Lungen besitzen über die A.pulmonalis sowie über die Bronchialarterien eine doppelte Blutversorgung. Normalerweise entsteht somit bei Verschluß einer Pulmonalarterie kein Lungeninfarkt. Bei Vorliegen einer Herzerkrankung mit pulmonaler Stauung kommt es im Falle einer Lungenembolie zur hämorrhagischen Infarzierung des betroffenen Lungenbezirks.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Adams WR, Veith I (editors): Pulmonary Circulation. Grune & Stratton, 1958.Google Scholar
  2. Allison PR & others: Pulmonary embolism. Thorax 1960; 15: 273.PubMedCrossRefGoogle Scholar
  3. Bedford DE & others: Bilharzial heart disease in Egypt: Cor pulmonale due to bilharzial pulmonary endarteritis. Br Hear J 1946; 8: 87.CrossRefGoogle Scholar
  4. Bell WR, Simon TL: A comparative analysis of pulmonary perfusion scans with pulmonary angiograms. Am Heart J 1976; 92: 700.PubMedCrossRefGoogle Scholar
  5. Bell WR, Simon TL, DeMets DL: The clinical features of submassive and massive pulmonary emboli. Am J Med 1977; 62: 355.PubMedCrossRefGoogle Scholar
  6. Bergofsky EH & others: Cardiorespiratory failure in kyphoscoliosis. Medicine 1959; 38: 263.PubMedCrossRefGoogle Scholar
  7. Burwell CS & others: Extreme obesity associated with alveolar hypoventilation: A Pickwickian syndrome. Am J Med 1956; 21: 811.PubMedCrossRefGoogle Scholar
  8. Camerini F & others: Primary pulmonary hypertension: Effects of nifedipine. Br Heart J 1980; 44: 352.PubMedCrossRefGoogle Scholar
  9. Christie RV: Emphysema of the lungs.Br Med J 1944; 1:143.PubMedCrossRefGoogle Scholar
  10. Clagett GP, Salzman EW: Prevention of venous thromboembolism in surgical patients. N Engl J Med 1974; 290: 93.PubMedCrossRefGoogle Scholar
  11. Comroe JH Jr:Physiology of Respiration, 2nd ed. Year Book, 1974.Google Scholar
  12. Crane C & others: The management of major pulmonary embolism. Surg Gynecol Obstet 1969; 128: 27.PubMedGoogle Scholar
  13. Dalen JE, Dexter L: Pulmonary embolism. JAMA 1969; 207:1505.PubMedCrossRefGoogle Scholar
  14. Davis HH & others: Alveolar-capillary oxygen disepuilibrium in hepatic cirrhosis. Chest 1978; 73: 507.PubMedCrossRefGoogle Scholar
  15. Dexter L: Thromboemboli as a cause of cor pulmonale. Bull NY Acad Med 1965; 41: 981.Google Scholar
  16. Dines DE & others: Pulmonary arteriovenous fistulas. Mayo Clin Proc 1974; 49: 460.PubMedGoogle Scholar
  17. Eberlein TJ, Carey LC: Comparison of surgical managements for pulmonary emboli. Ann Surg 1973; 179: 836.CrossRefGoogle Scholar
  18. Edwards WD, Edwards JE: Clinical primary pulmonary hypertension: Three pathologic types. Circulation 1977; 56: 884.PubMedGoogle Scholar
  19. Elkayam U & others: Unfavorable hemodynamic and clinical effects of isoproterenol in primary pulmonary hypertension. Cardiovasc Med 1978; 3:1177.Google Scholar
  20. Filley GF & others: Chronic abstructive bronchopulmonary disease. 2. Oxygen transport in two clinical types. Am J Med 1968; 44:26.PubMedCrossRefGoogle Scholar
  21. Fleming HA, Bailey SM: Massive pulmonary embolism in healthy people.Br Med J 1966: 1; 1322.PubMedCrossRefGoogle Scholar
  22. Fletcher CM & others: The diagnosis of pulmonary emphysema in the presence of chronic bronchitis. Q J Med 1963; 32: 33.PubMedGoogle Scholar
  23. Goldsmith RS: Infectious diseases: Helminthic. Chapter 26 in: Current Medical Diagnosis & Treatment 1981. Krupp MA, Chatton MJ (editors). Lange, 1981.Google Scholar
  24. Gray FD: Pulmonary Embolism: Natural History and Treatment. Lea & Febiger, 1966.Google Scholar
  25. Groote Schuur Hospital Thromboembolus Study Group: Failure of low-dose heparin to prevent significant thromboembolic complications in high-risk surgical patients: Interim report of prospective trial. Br Med J 1979: 1; 1447.CrossRefGoogle Scholar
  26. Gross NJ: Pulmonary effects of radiation therapy. Ann Intern Med 1977; 86: 81.PubMedGoogle Scholar
  27. Hall JC, Sutton GG, Kerr IH: Long-term prognosis of treated acute massive pulmonary embolism. BR Heart J 1977; 39:1128.PubMedCrossRefGoogle Scholar
  28. Harris P, Heath D: The Human Pulmonary Circulation, 2nd ed. Churchill Livingstone, 1977.Google Scholar
  29. Humphries JO, Bell WR, White RI: Criteria for the recognition of pulmonary emboli. JAMA 1976; 235: 2011.Google Scholar
  30. Kiil J & others: Prophylaxis against postoperative pulmonary embolism and deep-vein thrombosis by low-dose heparin. Lancet 1978; 1: 1115.PubMedCrossRefGoogle Scholar
  31. Klinke WP: Treatment for primary pulmonary hypertension. Am Heart J 1980; 100: 587.PubMedCrossRefGoogle Scholar
  32. Lie JT: Nosology of pulmonary vasculitides. (Editorial.) Mayo Clin Proc 1977; 52: 520.PubMedGoogle Scholar
  33. McDonald IG & others: Major pulmonary embolism: A correlation of clinical findings, haemodynamics, pulmonary angiography, and pathological physiology. Br Heart J 1972 34: 356.PubMedCrossRefGoogle Scholar
  34. McIlroy MB, Apthorp GH: Pulmonary function in pulmonary hypertension. Br Heart J 1958; 20: 397.PubMedCrossRefGoogle Scholar
  35. Mahmoud AA: Schistosomiasis. N Engl J Med 1977; 297:1329.PubMedCrossRefGoogle Scholar
  36. Miller GAH, Hall RJC, Paneth M: Pulmonary embolectomy, heparin and streptokinase: Their place in the treatment of acute massive pulmonary embolism. Am Heart J 1977; 93: 568.PubMedCrossRefGoogle Scholar
  37. Mitchell JRA: Can we really prevent postoperative pulmonary emboli? Br Med J 1979 1: 1523.PubMedCrossRefGoogle Scholar
  38. Moser KM: Pulmonary embolism. Am Rev Respir Dis 1977; 115: 829.PubMedGoogle Scholar
  39. Nichols AB & others: Scintigraphic detection of pulmonary emboli by serial positron imaging of inhaled 15O-labeled carbon dioxide. N Engl J Med 1978; 299: 279.PubMedCrossRefGoogle Scholar
  40. Oakley C, Somerville J: Oral contraceptives and progressive pulmonary vascular disease. Lancet 1968; 1: 890.PubMedCrossRefGoogle Scholar
  41. Rosenow EC III, Osmundson PJ, Brown ML: Pulmonary embolism. Mayo Clin Proc 1981; 56:161.PubMedGoogle Scholar
  42. Rubin LJ, Peter RH: Oral hydralazine therapy for primary pulmonary hypertension. N Engl J Med 1980; 302: 69.PubMedCrossRefGoogle Scholar
  43. Rudolph A & others: Effects of tolazoline hydrochloride (Priscoline) on circulatory dynamics of patients with pulmonary hypertension. Am Heart J 1958; 55: 424.CrossRefGoogle Scholar
  44. Shepherd JT & others: Clinical physiological and pathological considerations in patients with idiopathic pulmonary hypertension. Br Heart J 1957,19:70.PubMedCrossRefGoogle Scholar
  45. Short DS, Bedford DE: Solitary pulmonary hypertension. Br Heart J 1957; 19:93.PubMedCrossRefGoogle Scholar
  46. Sokolow M, Katz LN, Muscovitz AN: The electrocardiogram in pulmonary embolism.Am Heart J 1940; 19:166.CrossRefGoogle Scholar
  47. Stein PD, Willis PW III, DeMetst DL: History and physical examination in acute pulmonary embolism in patients without preexisting cardiac or pulmonary disease. Am J Cardiol 1981; 47: 218.PubMedCrossRefGoogle Scholar
  48. Sutton GC, Hall RJC, Kerr IH: Clinical course and late prognosis of treated subacute massive, acute minor and chronic pulmonary thromboembolism.Br Heart J 1977; 39:1135.PubMedCrossRefGoogle Scholar
  49. Tibbutt DA & others: Comparison by controlled trial of streptokinase and heparin in treatment of life-threatening pulmonary embolism. Br Med J 1974; 1: 343.PubMedCrossRefGoogle Scholar
  50. Wagenvoort CA, Wagenvoort N: Pathology of Pulmonary Hypertension. Wiley, 1977.Google Scholar
  51. Wang SWS & others: Diazoxide in treatment of primary pulmonary hypertension. Br Heart J 1978; 40: 572.PubMedCrossRefGoogle Scholar
  52. Watkins WD & others: Prostacyxlin and prostaglandin Et for severe idiopathic pulmonary artery hypertension. Lancet 1980; 1:183.Google Scholar
  53. Westlake EK & others: Carbon dioxide narcosis in emphysema. Q J Med 1955; 24:155.PubMedGoogle Scholar
  54. Wilhelmsen L, Hagman M, Werkö L: Recurrent pulmonary embolism: Incidence, predisposing factors and prognosis. Acta Med Scand 1972;192:565.PubMedCrossRefGoogle Scholar
  55. Wood P: Pulmonary hypertension. Br Med Bull 1952; 8: 348.PubMedGoogle Scholar

Copyright information

© Springer-Verlag, Berlin · Heidelberg 1985

Authors and Affiliations

  • Maurice Sokolow
    • 1
  • Malcolm B. Mcllroy
    • 2
  1. 1.University of CaliforniaSan FranciscoUSA
  2. 2.Cardiovascular Research InstituteUniversity of CaliforniaSan FranciscoUSA

Personalised recommendations