Interaction between Ventilation and Circulation in Bronchial Asthma and Pulmonary Emphysema
That the heart works as a pump in the respiratory pump and can be influenced by ventilatory events was recognized as early as the eighteen century by Valsalva and Morgani. However in normal conditions the ventilatory effects on the functionning of the cardiac pump are slight and negligible/ but in extreme situations , such as Valsalva or Muller maneuvers, the ventilatory forces may overcome the circulatory forces. Similarly, bronchial asthma attacks, chronic upper airway obstruction in children and sleep apnea syndrome resemble Muller maneuver (MM) during inspiration and, otherwise, bronchial asthma and emphysema resemble Valsalva maneuver (VM) during expiration, giving rise in the most severe cases to a kind of cardiac tamponade, reducing the venous return and limiting the circulatory adaptation to exercise.
KeywordsInferior Vena Cava Right Ventricle Chronic Bronchitis Venous Return Valsalva Maneuver
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