Cor Pulmonale

Question 1

Right Ventricular structure alteration due to pulmonary disease / hypoxia that may progress to right ventricular systolic / diastolic failure

Answer 1

Cor Pulmonale (R HF)

Question 2

What are the 5 most common causes of Cor Pulmonale

Answer 2

• COPD
  Pulm HTN
• Idiopathic pulmonary fibrosis
• Thromboembolic disease
• ARDS

Question 3

2 less common causes of Cor Pulmonale

Answer 3

• Pneumoconiosis
• Kyphoscoliosis

Question 4

• General term given to any lung disease caused by inhaled dust deposited in lungs
• “Occupational lung disease”
• Ex: asbestosis, silicosis, coal workers, black lung disease

Answer 4

Pneumoconiosis

Question 5

CP described as “pressure” or “tightness” or “squeezing” or “gas” rather than sharp is usually what?

Answer 5

Myocardial ischemia

Question 6

Cor Pulmonale

• SpO2 high or low?
• CVP high or low?

Answer 6

• SpO2 decreased
• CVP increased

Question 7

3 lab values for Cor Pulmonale

Answer 7

• CBC showing polycythemia secondary to chronic hypoxemia
• ABG showing hypoxemia +/- hypercapnic acidosis
• BNP

Question 8

3 dx tests for Cor Pulmonale

Answer 8

• EKG : RV hypertrophy and RBBB
• Echo: RV enlargement / hypertrophy
• Right Heart Cath: increased pulm artery pressure, increased vasc resistance, check response to O2/vasodilation

Question 9

Tx for acute or chronic Cor Pulmonale?

• Reverse hypoxia
• Improve RV contractility
• Decrease pulm vasc resistance
• CPAP for sleep apnea
• Phlebotomy
• Anticoagulate

Answer 9

Acute

Question 10

Tx for acute or chronic Cor Pulmonale?

• Long term O2 for hypoxic COPD pts
• Diuretics for RV volume overload
• CCBs, prostacyclin analogues, endothelin receptor antagonists for PAH
• Theophylline

Answer 10

Chronic

Question 11

Prognosis of Cor Pulmonale?

Answer 11

• 70% die within 5 years
• 30% chance of surviving 5 years
• Once sxs onset, life expectancy is 2-5 yrs