Wheezing is a nonspecific finding that results from increased airway reactivity. It may occur from bronchospasm related to reactive airway disease or from stretching of the bronchioles caused by congestion related to fluid and pressure build-up. Patients with CHF may develop wheezing, referred to as cardiac asthma, which then resolves with diuresis. An elevated JVP indicates elevated right heart pressures, which correlate with left-sided filling pressures. Pulsus alternans is a finding of varied intensity of the arterial pulse and is related to severe impairment of systolic function. Third heart sounds result from resistance to early diastolic filling of the ventricle and are related to increased pressure or wall thickness. An S3 gallop predicts a poor outcome. Cephalization on chest radiograph indicates engorgement of the pulmonary vasculature due to elevated pressures in the right heart.
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Seminars in Medical Practice
Hospital Physician Board Review Manuals
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