Cardiovascular pathophysiology

Pathological findings consistent with a massive outpouring of catecholamines have been demonstrated in the heart and pulmonary vascular endothelium. Contraction banding within the media of coronary arteries and ventricular myocytes and foci of myocardial necrosis may occur as a result of massive catecholamine release or decreased myocardial perfusion. Cardiac arrhythmias occur as a result of hypoxemia, respiratory and metabolic acidosis, and catecholamine surge. Vagally mediated cardiac arrhythmias occur as a result of peripheral alveolar flooding or the mammalian diving reflex. Ventricular fibrillation may follow myocardial ischemia and infarction or result from hypothermia.

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