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resistance in the pulmonary circulation, compared with the systemic circulation.

Pulmonary vascular pressures can be altered by a variety of physiologic and pathologic conditions. For example, mean pulmonary artery pressure can increase to more than 35 mm Hg during exercise, and pulmonary venous pressure can exceed 25 mm Hg in patients with congestive heart failure. Pressures in the pulmonary circulation also vary a small amount with the ventilatory cycle. This is because the heart is surrounded by intrapleural pressure, which decreases on inspiration and increases on expiration (Chapter 19). Consequently, vascular pressures tend to fall on inspiration.

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