THE CISTERNAL PRESSURE IN CONGESTIVE HEART FAILURE AND ITS BEARING ON ORTHOPNEA

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Abstract
In 5 patients without cardiac disease and in 5 with congestive heart failure, the systemic venous and lumbar spinal fluid pressures were greater in the sitting than in the prone position, and much greater in each position in the patients with congestive heart failure than in those without cardiac disease. The vital capacity was greater in the sitting than in the prone position in both groups and the parcentile increases of vital capacity with change in position was greater in the patients with cardiac disease. The cisternal pressure was much greater in each position in the group with congestive heart failure than in the other group. The cisternal pressure was much less in the upright than in the recumbent posture in each case and this difference in cisternal pressure between the 2 positions was much greater in patients with congestive heart failure than in those without cardiac disease. It is believed that in addition to the increase in vital capacity, the diminished cisternal pressure is an important factor in producing the relief from dyspnea obtained in the sitting position.

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