Cor Pulmonale

Question 1

What is cor pulmonale?

Answer 1

Cor pulmonale isright sided heart failure
caused byrespiratory disease.

The increased pressure and resistance in thepulmonary arteries (pulmonary hypertension) results in theright ventricle being unable to effectively pump blood out of the ventricle and into the pulmonary arteries.

This leads to back pressure of blood in the right atrium, thevena cavaand thesystemic venous system.

Question 2

Respiratory causes of Cor pulomale?

Answer 2

• COPD is the most common case
• Pulmonary Embolism
• ILD
• Cystic Fibrosis
• Primary Pulmonary Hypertension

Question 3

Presentation of cor pulomale?

Answer 3

• often asymptomatic
• main presenting complaint is shortbess of breath
• may present iwth peripheral oedema, increased breathlessness or exertion, syncope (dizziness and fainting) or chest pain

Question 4

Examine the patient for the signs of cop pulonale:

Answer 4

• hypoxia
• cyanosis
• raised JVP (due to back-log of blood in the jugular veins)
• peripheral oeema
• third heart sound
• murmurs (e.g. pan-systolic in tricuspid regurgitation)
• hepatomegaly due to back pressure in the hepatic vein (pulsatile in tricuspid regurgitation)

Question 5

Management

Answer 5

• treating the symptoms and the underlying cause
• long term oxygen therapy is often used
• prognosis poor unless reverisble underlying cause