Cor pulmonale

Question 1

what is the def of cor pulmonale ?

Answer 1

hypertrophy and dilatation of the RV
secondary to P HTN

Question 2

what are the causes of Cor pulmonale?

Answer 2

disease ofthe pulmonary parenchyma

chest wall and pulmonary vascular system

can be with or without RHF

Question 3

what are the exclusions of causes of Cor Pulmonale?

Answer 3

congeital heart disease and LHF

Question 4

explain the classification of Cor Pulmonale

Answer 4

Acute - massive pulmonary embolism
chronic

Question 5

what is Acute Cor Pulmonale?

Answer 5

refering to the developent of acute P HTN
and right ventricular overload from massive embolism
with following developent of R dilatation.

Question 6

explain the event of the developent of acute cor pulmonale

Answer 6

The primary event is the embolism, which directly causes pulmonary hypertension.

This, in turn, overloads the right ventricle, leading to its dilatation and the development of acute Cor pulmonale.

Question 7

explain the stages of chronic Cor pulmonale

Answer 7

due to chronic lung disease

compensated Cor pulmonale when RVH and P HTN occur

Decompensated COr pulmonale when RHF occur

Question 8

what are the obstrctive etiologies ?

Answer 8

COPD - 80-90% of cases
asthma
bronchiectasis
bronchioletis obliterans

Question 9

what are the restrictive etiologies ?

Answer 9

idiopathic fibrosis
fibrosis assocaited with collagen disease
sarcoidosis
pneumoconiosis

Question 10

what are the restrctive extrapulmonary etiologies ?

Answer 10

Obesity
kyphoscolisosi
poliomyelitis
Guillain-Barre syndrome

Question 11

explain the pathophysiology

Answer 11

formation of P HTN –> cardiac disorders and HF –> damage to other cital organs

Question 12

which funcitonal factor is the most important in P HTN?

Answer 12

hypoxia is most important factor
determined by ratio of vasovonstrictive and vasodilative substances

acidosis increases sensitivity of vasoconstriction to hypoxia

Question 13

anatomical factors of vascular resistance ?

Answer 13

vasculitis
emphysema - increase intraalveolar pressure
vascular remodeling
multi pulmonary micro-arterial thrombosis

Question 14

explain what increased blood colime and hyperviscosity do

Answer 14

casuing p HTN, secondary polycythemia
water and sodium retion
- alodsterone
- renal ateriole constriction

Question 15

what are the clinical presentations

Answer 15

dyspnea
cough wiht or without sputum
syncope
chest pain

Question 16

what are the clinicla assesment

Answer 16

observed at advanced stage of pulmonary HTN
occuring late
ankle edema
tricuspid regurgitation murmur
pulmonary component of second heart sound
pulses paradoxus

Question 17

what is seen in X ray in Cor Pulmonale

Answer 17

dilated ateries and trunk
right lower A ove r6 mm
left artery over 18 mm
dilation of RV

Question 18

what is seen incardiac ultrasound ?

Answer 18

dilated and hypertrophy right ventricle and atrium
increassed pulmonary artery dimension
regurgitation

Question 19

How is the arterial blood gas analysis ?

Answer 19

hypoxemia and/or hypercapnia
respiraotry failure
- PaO2 < 60 mmHg
- PaCO2 > 50 mmHg

Question 20

how is the serum assessment ?

Answer 20

• increased RBC coun and hemoglobin
• increased blood and plasma viscosity
• electroliyte imbalance
• renal and hepatic dysfunction

Question 21

how is the diagnosis made ?

Answer 21

history of COPD and parenchymal, chst wall pulmonary vacular disease
symptons and sign of RHF, P HTN
X-ray and ECG, UCG

Question 22

what is the treatment for Cor Pulmonale

Answer 22

treatment of the underlying disease

Question 23

what are used in the treatment of Cor Pulmonale-?

Answer 23

O2 therapy
diuretics
digitalis
vasodilators
control of infection