FLUID DYNAMICS IN CHRONIC CONGESTIVE HEART FAILURE

Abstract

Many theories have been formulated in an attempt to explain the clinical features and laboratory findings of chronic congestive heart failure. Today most medical students are taught that the venous pressure becomes elevated because blood is dammed up in the venous system when the ability of the heart to pump blood forward is impaired. Edema is said to occur primarily as a result of this increase in venous pressure, with increased capillary permeability and decreased colloid osmotic pressure of the blood as contributing factors. Nevertheless, there are many clinical and experimental observations which are not consistent with this usually accepted theory. The purpose of this presentation is to summarize these objections and to offer a more satisfactory explanation of the physiologic abnormalities producing the edema, the increased blood volume and the elevated venous pressure of certain patients with congestive heart failure. Few new data are presented, but the findings of