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Congestion of Lung
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Congestion of Lung

Sections of fresh pulmonary parenchyma.
Note deep red color with preservation of underlying architecture.
Normal should be pink-tan.
(Description By:Melinda Sanders, M.D. )
(Image Contrib. by: Saint Francis Hospital )
Pulmonary Vascular Congestion
Etiology

Generally associated with left-sided heart failure
Etiology of heart failure includes myocardial damage associated with valvular, coronary arterial, or intrinsic myocardial injury
Other causes include blood loss andperipheral vasodilatation (shock)
Pathogenesis

Increased left atrial pressure leads to increased pulmonary venous pressure and then to increased pulmonary capillary pressure with congestion and ultimately transudation into the alveolar space(edema),
Epidemiology

Ischemic cardiac disease is leading cause of death in U.S.
Variety of disease processes result in left sided failure.
General Gross Description

Heavy wet lungs
Deep red
Ooze bloody fluid on sectioning
When chronic, rusty discoloration may occur
General Microscopic Description

Dilated blood vessels containing abundant RBC's
Scattered RBC's may be found in the alveoli due to diapedesis which lead to
Hemosiderin-laden macrophages (heart failure cells) appearing within a few days
Protein-rich edema fluid may also be present
Clinical Correlation

Dyspnea first on exertion, then lying down (orthopnea) and then at rest
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 521-522.
Pulmonary Vascular Congestion
Synopsis by: Melinda Sanders M.D. (T28000M36142)[114]
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