Pediatricsadvanced
Explain how RCM can cause both systemic venous congestion and pulmonary congestion.
Answer
Poor ventricular compliance impairs diastolic filling and raises filling pressures. Elevated venous pressures can cause edema, ascites, hepatomegaly, and raised venous pressure. High left atrial filling pressures contribute to pulmonary congestion and place the patient at risk of pulmonary vascular disease.
Explanation
A stiff ventricle fills inadequately, so pressures rise upstream from the affected chambers. Systemic venous congestion is reflected by **edema, ascites, hepatomegaly, and increased venous pressure**. High left atrial filling pressures contribute to pulmonary congestion and may lead to pulmonary vascular disease. **Key takeaway:** Restrictive filling creates congestion on both the systemic and pulmonary sides of the circulation.\n\n**Glossary:** **Ascites**: Fluid accumulation in the abdomen. **Pulmonary vascular disease**: Disease affecting blood vessels in the lungs.
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