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February 1970

Mitral Stenosis and Pulmonary Fibrosis: Special Reference to Pulmonary Edema and Lung Lymphatic Function

Author Affiliations


From the Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh. Dr. Cross is now with the Cardiopulmonary Section, Department of; Medicine, University of California at Davis School of Medicine, Davis, Calif.

Arch Intern Med. 1970;125(2):248-254. doi:10.1001/archinte.1970.00310020054003

Three patients had coexisting pneumoconiosis and mild mitral stenosis in which pulmonary edema was the presenting clinical manifestation. Hemodynamic abnormalities seemed quantitatively insufficient to account for the degree of pulmonary edema. In spite of the mild mitral stenosis, surgical relief produced a gratifying clinical response in all three patients. The discrepancy between symptoms and the hemodynamic abnormalities was consistent with a contributory role of pulmonary lymphatic obliteration. We have attempted to define the mechanism by which coexisting pulmonary lymphatic abnormalities might alter the course of heart diseases characterized by elevations of pulmonary capillary pressure. These patients also present the opportunity to review some recent concepts concerning the mechanisms of pulmonary edema.

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