Pulmonary Supoplemental

Question 1

Cor Pulmonale

Answer 1

Disease of Right Ventricle that results from Pulm HTN 2/2 to pulm dz
R ventricular dilatation, hypertrophy and eventual right sided HF
E: Acute (PE, ARDS); Chronic (COPD, Restrictive Lung Dz)
S/Sx: Peripheral Edema, JVD, Hepatomegaly, Dyspnea
CXR: Widening of Pulm arteries
EKG: Flat or inverted T waves in R vent lead, RAD, RBBB
Tx:
Medical: Correct hypoxemia/acidosis, O2, diuretics, vasodilators
Surgical: VAD, biventricular pacing, transplant

Question 2

Cor Pulmonale

Answer 2

Chronic, slow progressing disease
Patients with lower extremity edema, COPD and pulmonary HTN often have a 5 year survival rate of 30%
Severe Right sided heart failure can cause hepatic congestion/ascites

Question 3

Pulmonary HTN:

Answer 3

Vasoconstrictive effects in pulmonary arteries
E: Hypoxia, acidosis, Lung resection, emphysema, PE, sickle cell, Mitral stenosis, LV failure
S/Sx: Dyspnea, cough, CP, hemoptysis, fatigue, syncope
Dx: Right heart cath > ECHO
Tx: Aimed at cause; O2, diuretics, anticoagulants, exercise
Epoprostenol, prostacyclin, Calcium Channel Blockers, Nitrous Oxide, sildenafil