Cor pulmonale

Question 1

What is cor pulmonale

Answer 1

Right heart failure caused by pulmonary arterial HT

Question 2

Cor pulmonale symptoms

Answer 2

Dyspnoea
Fatigue
Syncope

Question 3

Cor pulmonale signs

Answer 3

Cyanosis

Tachycardia
RV heave

Oedema
Raised JVP
Hepatomegaly

Question 4

Cor pulmonale sounds

Answer 4

Loud p2
Pansystolic murmur
Early diastolic Graham Steell murmur

Question 5

Cor pulmonale investigations

Answer 5

2˚ polycythaemia so haematocrit + Hb raised
Hypoxia ± hypercapnia
CXR shows enlarged RA and RV, prominent pulmonary arteries
ECG shows p pulmonale, right axis deviation, RV hypertrophy

Question 6

Cor pulmonale management

Answer 6

Treat underlying cause
Treat resp failure (24% O2 and LTOT if needed in COPD)

Treat cardiac failure with diuretics, K+ supplements if needed
Consider venesection if haematocrit >55%

Consider heart-lung transplant in young pt

Question 7

Cor pulmonale prognosis

Answer 7

50% die in 5yrs

Question 8

Cor pulmonale causes

Answer 8

Lung disease (COPD, severe chronic asthma, bronchiestasis)
Pulmonary vascular disease (including ARDS + sickle cell)
Thoracic cage abnormality
Neuromuscular disease (MG, MND, polio)
Hypoventilation
Cerebrovascular disease