Acute pulmonary edema (APE) is one of the acute complications of left-sided HF.
Management:
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Hospitalization.
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Semi-setting or sitting position.
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Oxygen: reduce pulmonary capillary pressure and edema.
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Morphine: (5 mg i.v.) because: Analgesic effect → ↓ stress of the patient. Venodilatation → ↓ VR → ↓ lung congestion. It ↓ pulmonary stretch reflex → ↓ tachypnea → ↓ exhaustion of the patient.
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Diuretics: (furosemide 40 mg i.v.) because: It ↓ pulmonary wedge pressure → ↓ pulmonary edema. Diuretic effect and ↓ ECF volume (preload). It ↓ systemic BP (afterload).
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Rapid digitalization (0.25 mg i.v.): provided that there are no contraindications.
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Aminophylline: (250 mg slowly i.v.) because: It causes bronchodilatation. It ↑ myocardial contractility. It ↑ RBF → diuretic effect.
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Treatment of the precipitating factor: e.g. hypertension Use….. Vasodilators as nifedipine or captopril sublingual…………………..