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Does any know the pathophys involved R--> L blood shunt caused by pulmonary edema, pneumonia, and chronic liver disease ? These are listed as the possible causes of the shunt in a high yield book. Thanks
In those two lung diseases, some alveoli are not ventilated, so blood flows from the right heart to the left heart without gas exchange, a physiological shunt (as opposed to anatomical shut such as ASD/VSD).
In chronic liver disease, I'm not sure, but I think it has to do with high pressure in the portal system causes anastomoses, like caput medusa and esophageal varices. Not sure how that is a shunt though, because it should all end up in the right heart eventually.
do you guys know what a left parasternal heave is? it is a sign of right ventricular hypertrophy, but i don't know what the heck "parasternal HEAVE" is... and why left instead of right?
L parasternal = area that borders Left-side of sternum (i.e., around where the heart is located)
Heave = while placing your hand over the area, the hand is actually lifted up off the chest due to an abnormally strong impulse from the heart (indicating RVH)