Pulmonary Heart Disease

Clinical—Physiologic Variants

¹ Assistant Professor of Medicine, Tufts University School of Medicine, Lung Station (Tufts), Boston City Hospital
² Clinical Professor of Medicine, Tufts University School of Medicine and Director, Lung Station (Tufts), Boston City Hospital

The pulmonary heart disease syndrome is a multiform complex whose evolution is determined by the natural history of the underlying disorders. It should be recognized that considerable physiologic derangement may long precede the clinical evidence of heart failure and that the recognition of this fact has significant therapeutic implications. The development of the syndrome is essentially determined by the interplay of physiologic factors such as hypoxia, pulmonary arteriolar resistance and cardiac output, acting upon varying degrees of established curtailment in the effective areas of the pulmonary vascular bed. Some highlights in therapy are discussed.