Cor Pulmonale Flashcards
What is Cor Pulmonale?
caused by right-sided heart failure caused by chronic pulmonary arterial hypertension
What are the lung diseases that cause Cor Pulmonale?
- COPD
- Bronchiectasis
- Pulmonary fibrosis
- Severe chronic asthma
- Lung resection
What are the thoracic cage abnormalities that can cause cor oulmonale?
- Kyphosis
- Scoliosis
- Thoracoplasty
What are the pulmonary vascular disease that can cause cor pulmonale?
- Pulmonary emboli
- Pulmonary vasculitis
- Primary pulmonary hypertension
- ARDS
- Sickle-cell disease
- Parasite infestation
what are the neuromuscular disease that can cause cor pulmonale?
- Myasthenia gravis
- Poliomyelitis
- Motor Neuron Disease (MND)
What hypoventilation syndromes can cause cor pulmonale?
- Sleep apnoea
* Enlarged adenoids in children
What are the symptoms of cor pulmonale?
o Dyspnoea
o Fatigue
o Syncope
What are the clinical signs of cor pulmonale?
o Cyanosis o Tachycardia o Raised JVP o Early diastolic Graham Steell murmur o RV heave o Loud P2 o Pansystolic murmur o Hepatomegaly o Oedema
What investigations should be carried out in cor pulmonale?
• FBC o increased Hb and haematocrit • ABG o Hypoxia with or without hypercapnia • CXR o Enlarged right atrium and ventricle o Prominent pulmonary arteries • ECG o P pulmonale o Right axis deviation o Right ventricular hypertrophy/strain
What are the main management methods in cor oulmonale?
• Treat underlying cause
• Treat respiratory failure
o In acute situations give 24% oxygen if PaO2 <8kPa
o Monitor ABG and gradually increase oxygen concentration if PaCO2 is stable
o In COPD patients – long term oxygen therapy
• Treat cardiac failure
o With diuretics (furosemide)
o Monitor U&E
o Give amiloride or potassium supplements if necessary
• Consider venesection if haematocrit >55%
• Consider heart-lung transplant in young patients
