The peripheral manifestations, such as hepatic and pulmonary congestion, engorgement of the veins and edema, that accompany an impaired circulation are conventionally explained by assuming that with the failing heart action there is a rise in pressure in the right auricle which impedes the venous flow to the heart; that this, in turn, causes engorgement of the veins and a heightened venous pressure which eventually is transmitted to the capillaries. "The increased venous pressure spreads to the peripheral parts, acting not only so as to dilate the peripheral vessels, but also to retard the capillary flow. The increased capillary pressure results in an exemia or filtration of fluid into the capillary spaces, which is responsible for the edema and ascites on the one hand, and the concentration of blood evidenced by polycythemia on the other."1
Measurements of the venous pressure in patients with myocardial insufficiency have been adduced to support
BOAS EP, DOONEIEF G. THE MECHANISM OF PERIPHERAL STASIS IN MYOCARDIAL INSUFFICIENCY: CAPILLARY AND VENOUS PRESSURES. Arch Intern Med (Chic). 1924;33(4):407–414. doi:10.1001/archinte.1924.00110280003001
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