Cor Pulmonale Flashcards
About Cor Pulmonale
Cor pulmonale (cor = heart; pulmonale = lung) or pulmonary heart disease is the disease of right side of the heart resulting from disorders of the lungs.
It is characterised by right ventricular dilatation or hypertrophy, or both.
Thus, cor pulmonale is the right-sided counterpart of the hypertensive heart disease.
Depending upon the rapidity of development, cor pulmonale may be acute or chronic:
- Acute cor pulmonale occurs following massive pulmonary embolism resulting in sudden dilatation of the pulmonary trunk, conus and right ventricle.
- Chronic cor pulmonale is more common and is often preceded by chronic pulmonary hypertension. Following chronic lung diseases can cause chronic pulmonary hypertension and subsequent cor pulmonale:
- Chronic emphysema
- Chronic bronchitis
- Pulmonary tuberculosis
- Pneumoconiosis
- Cystic fibrosis
- Hyperventilation in marked obesity (Pickwickian syndrome)
- Multiple organised pulmonary emboli
Cor Pulmonale; Pathogenesis.
- Chronic lung diseases as well as diseases of the pulmonary vessels cause increased pulmonary vascular resistance.
- The most common underlying mechanism causing increased pulmonary blood pressure (pulmonary hypertension) is by pulmonary vasoconstriction, activation of coagulation pathway and obliteration of pulmonary arterial vessels.
- Pulmonary hypertension causes pressure overload on the right ventricle and hence right ventricular enlargement.
- Initially, there is right ventricular hypertrophy, but as cardiac decompensation sets in and right heart failure ensues, dilatation of right ventricle occurs.
Cor Pulmonale; Morphology.
In acute cor pulmonale, there is characteristic ovoid dilatation of the right ventricle, and sometimes of the right atrium.
In chronic cor pulmonale, there is increase in thickness of the right ventricular wall from its normal 3 to 5 mm up to 10 mm or more. Often, there is dilatation of the right ventricle too
