4. Cor Pulmonale Flashcards
Define Cor Pulmonale.
It is a Pulmonary Heart Disease characterized by dilatation and hypertrophy of the Right Ventricle, in response to diseases of pulmonary vasculature or lung parenchyma.
State the common aetiologies of Cor Pulmonale.
- Hypoxemic Vasoconstriction
- Occlusion of Vasculature
- Parenchymal Diseases
What causes hypoxemic vasoconstriction?
- COPD
- Chronic Bronchitis
- Cystic Fibrosis
- Obesity
- Neuromuscular disorders
- Chest wall dysfunction
What causes occlusion of vasculature?
- Thromboembolic events
- Pulmonary hypertension
- Veno-occlusive disorders
What causes parenchymal diseases?
- COPD
- Chronic Bronchitis
- Bronchiectasis
- Cystic Fibrosis
- Pneumoconiosis
- Sarcoidosis
- Interstitial Lung Disease (ILD)
Explain the pathophysiology of Cor Pulmonale.
The wall of the R.V is thin. Alveolar Hypoxia causes Hypoxic Pulmonary Vasoconstriction. This leads to increased Pulmonary Vasculature which causes Pulmonary Hypertension. This leads to increased R.V overload causing the R.V to hypertrophy and eventually, fail.
State the common symptoms complained by a Cor Pulmonale patient.
- Dysapnea
- Tussive/Effort related syncope (Pass out)
- Abdominal pain
- Ascites
State the common signs elicited in a Cor Pulmonale patient.
- Tachypnoea
- Elevated JVP (Prominent V waves)
- Hepatomegaly
- Oedema
- RV Heave
- Cyanosis
How do you confirm your diagnosis of Cor Pulmonale?
Conduct imaging on the patient
What imaging tests would you conduct?
- ECG (P. Pulmonale, RVH and RAD)
- Chest X-Ray (Enlarged Pulm. Vasculature)
- Echocardiography
- CT Thorax (Thromboembolic events)
How do you treat a patient with Cor Pulmonale?
- Target the underlying pulmonary condition and infection.
- Provide Non-Invasive Ventilation, Bronchodilators and adequate oxygenation via Long Term O2 Generator (L.T.O.G)
- Correct anaemia, if present
- Start Phlebotomy in Polycythemia, if present
- Provide diuretics, digoxin and pulmonary vasodilators if necessary.
