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A ventilation perfusion scan or lung scintigraphy can be used to diagnose areas of lungs being ventilated but not adequately perfused. This results in a raised Alveolar-arterial (A-a) gradient which is responsive to supplemental oxygen. In conditions with right to left shunts, there are also ventilation perfusion defects with high A-a gradients.
By redirecting blood flow from poorly-ventilated lung regions to well-ventilated lung regions, HPV is thought to be the primary mechanism underlying ventilation/perfusion matching. [1] [2] The process might initially seem counterintuitive, as low oxygen levels might theoretically stimulate increased blood flow to the lungs to increase gas exchange.
A pulmonary shunt is the passage of deoxygenated blood from the right side of the heart to the left without participation in gas exchange in the pulmonary capillaries. It is a pathological condition that results when the alveoli of parts of the lungs are perfused with blood as normal, but ventilation (the supply of air) fails to supply the perfused region.
Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by chronic respiratory symptoms and airflow limitation. [8] GOLD 2024 defined COPD as a heterogeneous lung condition characterized by chronic respiratory symptoms (dyspnea or shortness of breath, cough, sputum production or exacerbations) due to abnormalities of the airways (bronchitis ...
This is known as hypoxic pulmonary vasoconstriction, or "HPV", and has the effect of redirecting blood away from poorly ventilated regions, which helps match perfusion to ventilation, giving a more even oxygenation of blood from different parts of the lungs. [81]
Hypoxemia is caused by five categories of etiologies: hypoventilation, ventilation/perfusion mismatch, right-to-left shunt, diffusion impairment, and low PO 2. Low PO 2 and hypoventilation are associated with a normal alveolar–arterial gradient (A-a gradient) whereas the other categories are associated with an increased A-a gradient.
Hypoventilation is not synonymous with respiratory arrest, in which breathing ceases entirely and death occurs within minutes due to hypoxia and leads rapidly into complete anoxia, although both are medical emergencies. Hypoventilation can be considered a precursor to hypoxia, and its lethality is attributed to hypoxia with carbon dioxide toxicity.
Recurrent airway obstruction, also known as broken wind, heaves, wind-broke horse, or sometimes by the term usually reserved for humans, chronic obstructive pulmonary disease or disorder (COPD) – it is a respiratory disease or chronic condition of horses involving an allergic bronchitis characterised by wheezing, coughing and laboured breathing.