Does elevated RVEDP cause dyspnea ?

Exertional dyspnea disproportional to the effort is the most common (cardinal)symptom of heart disease. Whenever we discuss the mechanism of cardiac dyspnea , we primarily attribute it to left heart disease, elevated LVEDP and the resultant pulmonary congestion.Conventional teaching in the past (may be in the present too !) doesn’t implicate raised RVEDP in the genesis of dyspnea. It’s good to recall , the sensation of dyspnea is felt at the peri -Amygdala nuclear zone after complex processing with various cortical and sub-cortical level .It is subjected to as many afferent triggers other than J receptors in pulmonary micro circulation. (Eg Exercising skeletal muscle). It is believed, mechanical stretch receptors exist within the walls of heart along  the sub-endocardial aspects of chamber. (Muscle spindles which are the sensors of muscle tension are extensively noted in skeletal muscle that contribute to the origin of dyspnea .We are not yet accruing enough evidence  whether cardiac muscle do have the same muscle spindle or it’s equivalents to cause dyspnea when stretched. However, we clearly witness in the practice of clinical cardiology , isolated elevation of RVEDP ( also RVSP ) to cause significant dyspnea in specific clinical situations. Potential causes for Isolated Right ventricular dyspnea Pulmonary hypertension  (COPD included* where in it could be a combination of lung and cardiac dyspnea) Acute pulmonary embolism RV Infarction Iso...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Cardiology - Clinical Clinical cardiology Uncategorized does raised rvedp cause dyspnea dyspnea in pulmonary hypertension mechanism of dyspnea Source Type: blogs

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