Cor Pulmonale

Question 1

What is Cor Pulmonale?

Answer 1

Pulmonary heart disease or failure

Question 2

What are the etiologies of Cor Pulmonale?

Answer 2

RV dysfunction in the context of chronic lung disease and its the end result of PHTN

It can be an acute RV failure due to a sudden blockage of pulmonary vessels. (PE)

Question 3

What the symptoms of Cor Pulmonale?

Answer 3

Fatigue, dyspnea, angina, cough, syncope, swelling

Question 4

What clinical findings would you find examining a pt with Cor Pulmonale?

Answer 4

• Signs of respiratory distress (tachypnea, accessory muscle use, retractions)
• Edema (lower extremities, ascites, lung rales/crackles)
• Respiratory Failure
• Death

Question 5

What diagnostics would you order if you suspect Cor Pulmonale?

Answer 5

• Ekg: showing RV enlargement or strain, maybe dysrhythmias due to dilation
• Chest X ray: right side enlargement of the heart, prominent pulmonary artery

Question 6

Cor Pulmonale Tx?

Answer 6

-Supplemental O2
-Meds
Inotropic meds- Dobutamine 1st line
Phosphodiesterase inhibitor- Milrinone- 2nd line to reduce resistance
Possibly intubation with low airway pressures

Question 7

What are two tx that you should never do for a pt with Cor Pulmonale?

Answer 7

• Do not overfill vascular volume
• Do not put pt on ventilator with high settings.