While this procedure usually generates only limited scar tissue, in rare cases a fibrothorax can develop. Mechanism
Fibrosis can affect one or both of the two layers of tissue forming the pleura—the visceral pleura adjacent to the lung and the parietal pleura adjacent to the ribcage. The term fibrothorax implies severe fibrosis affecting both the visceral and the outer (parietal) pleura, fusing the lung to the chest wall. The condition starts as an undrained pleural effusion. Over time, the undrained pleural effusion causes sustained inflammation of the pleura, which can then lead to deposition of fibrin in the pleura and the development of a fibrotic scar. Eventually, a "peel" that is rich in collagen forms around the fluid collection. From this point, the illness can no longer be treated with thoracentesis, since the fluid will return to the cavity maintained by the peel.Over time, generally over the years, the fibrotic scar tissue slowly tightens and thickens, contracting the contents of one or both halves of the chest and reducing the mobility of the ribs. The peel can become deeper than 2 cm. Within the chest, the lung is compressed and unable to expand (trapped lung), making it vulnerable to collapse and causing breathlessness. Restrictive lung disease from fibrothorax may occur when pleural fibrosis is so severe that it involves the diaphragm and ribcage and results primarily from decreased rib movement. Microscopic
At the microscopic level, collagen fibres deposit in a basket weave pattern and form scar tissue.
Trandolapril/verapamil (Tarka) is an oral antihypertensive medication that combines a slow release formulation of verapamil hydrochloride, a calcium channel blocker, and an immediate release formulation of trandolapril, an ACE inhibitor. The patent, held by Abbott Laboratories, expired on February 24, 2015. This combination medication contains angiotensin-converting enzyme (ACE) inhibitor and calcium channel blocker and is prescribed for high blood pressure. References
External links
"Trandolapril mixture with verapamil hydrochloride". Drug Information Portal. U.S. National Library of Medicine.