THE INTRAPLEURAL PRESSURE IN CONGESTIVE HEART FAILURE AND ITS CLINICAL SIGNIFICANCE 1

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Abstract
From simultaneous tracings of the tidal air and intrapleural pressure, a marked decrease in distensibility and slight impairment of elasticity of the lung can be demonstrated in heart failure with congestion. The significance of these changes with regard to dyspnea, hemo-respiratory exchange, and the characteristic changes in the lung volume are discussed. Expiration in congestive heart failure is, in part, the result of positive intrapleural pressure generated by active muscular effort. The functional drawbacks of this type of expiration are emphasized, in particular diminution in the excursion of the diaphragm, with consequent impairment of inspiratory efficiency. The significance of increased intrapleural pressure, in its relationship to venous pressure and the return of venous blood to the heart, is emphasized.

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