Pulmonary venous hypertension

Pulmonary hypertension may occur from blockage of the left atrium by a myxoma or thrombus.

Congenital and acquired heart lesions can cause pulmonary venous hypertension.

Congenital causes include hypoplastic left heart syndrome, aortic coartation, interrupted aortic arch, anomalous origin of a coronary artery, valvular aortic stenosis, cor triartrium, total anomalous pulmonary connection below the diaphragm and pulmonary vein stenosis or atresia.

Pulmonary venous hypertension necessitates a passive rise in pulmonary systolic pressure to maintain a driving force across the vasculature.

Volume overloaded cause shear force injury to the vascular endothelium, which leads to vascular remodeling and luminal narrowing.

Pulmonary venous hypertension may be identified on radiographs, pulmonary angiogram or nuclear medicine perfusion scans.

Pulmonary venous hypertension is considered mild with wedge pressures of 10 to 13 mm Hg, moderate with equalization of upper and lower lobe blood flow and wedge pressures of 14 to 16 mm Hg.
Pulmonary venous hypertension

Pulmonary venous hypertension

The most frequent encountered causes of pulmonary hypertension with left heart disease previously referred to as pulmonary venous hypertension in the Evian system and now referred to as pulmonary hypertension caused by left heart disease.

Pulmonary venous hypertension is another term for post-capillary pulmonary hypertension and is a result of increased resistance in the pulmonary veins. It is an important cause of secondary pulmonary arterial hypertension.

Pulmonary venous hypertension is defined by a measurement of pulmonary venous pressure equal to or more than 18 mmHg.

Increased pulmonary venous pressure may lead to functional and structural changes in the pulmonary circulation. It may cause by conditions such as left ventricular failure, mitral regurgitation or mitral stenosis. 

Pulmonary vascular redistribution denotes dilatation of the upper lung vessels and relative vasoconstriction of the lower lung vessels.

In addition to the passive increase in pulmonary blood volume, active vasoconstriction also occurs in the pulmonary vascular bed.
Pulmonary venous hypertension