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Related Concept Videos

Pulmonary Hypertension: Classification and Pathogenesis01:30

Pulmonary Hypertension: Classification and Pathogenesis

Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
Pulmonary Cycle: Exhalation01:17

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
Pneumothorax-I01:26

Pneumothorax-I

A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Pulmonary Embolism I: Introduction01:29

Pulmonary Embolism I: Introduction

Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
Pulmonary Edema II: Pathophysiology01:18

Pulmonary Edema II: Pathophysiology

Pulmonary edema is the accumulation of fluid in the interstitial and alveolar spaces of the lungs, impairing gas exchange and oxygen delivery. It may be cardiogenic or noncardiogenic, but both reduce oxygenation and lung compliance.Cardiogenic Pulmonary EdemaCardiogenic edema results from increased hydrostatic pressure in pulmonary capillaries, usually due to left ventricular dysfunction from myocardial infarction, heart failure, or valvular disease. Ineffective cardiac pumping causes blood to...

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Related Experiment Video

Updated: Jul 5, 2026

Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets
08:08

Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets

Published on: May 11, 2015

P pulmonale in status asthmaticus.

A F Gelb, H A Lyons, R D Fairshter

    The Journal of Allergy and Clinical Immunology
    |July 1, 1979
    PubMed
    Summary

    Severe asthma attacks can cause P pulmonale, an electrocardiogram finding, in nearly half of patients with high carbon dioxide levels. This condition, linked to right heart strain, can persist even after initial treatment.

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    Area of Science:

    • Cardiology
    • Pulmonology
    • Critical Care Medicine

    Background:

    • Acute, severe asthma attacks present significant physiological challenges.
    • Electrocardiographic (ECG) findings in asthma patients require further investigation.

    Purpose of the Study:

    • To investigate the prevalence and underlying mechanisms of P pulmonale in patients experiencing acute, severe asthma.
    • To explore the relationship between arterial blood gas levels and ECG abnormalities.
    • To determine the duration of P pulmonale persistence and its potential causes.

    Main Methods:

    • Studied 129 patients during acute, severe asthmatic attacks.
    • Utilized electrocardiograms (ECGs) to identify P pulmonale.
    • Analyzed arterial carbon dioxide tension (PaCO2) and arterial pH.
    • Performed cardiac catheterization in a subset of patients with P pulmonale and respiratory acidosis.

    Main Results:

    • P pulmonale was observed in 49% of patients with PaCO2 ≥ 45 mm Hg and pH ≤ 7.37, versus 2.5% in those with PaCO2 ≤ 44 mm Hg and pH ≥ 7.38 (p < 0.001).
    • P wave and QRS axes were significantly shifted in the presence of P pulmonale and normalized upon its disappearance.
    • ECG P pulmonale persisted for 12–60 hours after correction of hypoxemia, hypercapnia, and acidosis.
    • Cardiac catheterization revealed normal pulmonary artery pressures (PAPs) but increased peak inspiratory pulmonary artery transmural pressures (PATPs) in patients with P pulmonale and respiratory acidosis.

    Conclusions:

    • Reversible P pulmonale in status asthmaticus is associated with severe hypercapnia and acidosis.
    • The findings support the hypothesis that negative tidal pleural pressures and increased right heart transmural pressures contribute to P pulmonale.
    • P pulmonale may indicate right heart strain due to altered intrathoracic pressures during severe asthma exacerbations.