Pulmonary heart disease
Pulmonary heart disease | |
---|---|
Other names | Cor pulmonale |
Right ventricular hypertrophy | |
Specialty | Pulmonology |
Symptoms | Cyanosis, wheezing[1] |
Causes | Primary pulmonary hypertension[2] |
Diagnostic method | EKG, Thrombophilia screen[1] |
Treatment | Vasodilators, Diuretics[3] |
Pulmonary heart disease, also known as cor pulmonale, is the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance (such as from pulmonic stenosis) or high blood pressure in the lungs.[2]
Chronic pulmonary heart disease usually results in
To be classified as pulmonary heart disease, the cause must originate in the
Signs and symptoms
The symptoms/signs of pulmonary heart disease (cor pulmonale) can be non-specific and depend on the stage of the disorder, and can include blood backing up into the
- Shortness of breath
- Wheezing
- Cyanosis
- Ascites
- Jaundice
- Enlargement of the liver
- Raised jugular venous pressure (JVP)
- Third heart sound
- Intercostal recession
- Presence of abnormal heart sounds
Causes
The causes of pulmonary heart disease (cor pulmonale) are the following:
- Acute respiratory distress syndrome (ARDS)[10]
- COPD[2]
- Primary pulmonary hypertension[2]
- Blood clots in lungs[2]
- Kyphoscoliosis[2]
- Interstitial lung disease[2]
- Cystic fibrosis[2]
- Sarcoidosis[11]
- Obstructive sleep apnea (untreated)[2]
- Sickle cell anemia[12]
- Bronchopulmonary dysplasia (in infants)[13]
Pathophysiology
The pathophysiology of pulmonary heart disease (cor pulmonale) has always indicated that an increase in right ventricular afterload causes RV failure (pulmonary
- Ischemia
- Inflammation
- Oxidativedamage
- Epigenetics
- Abnormal cardiac energetics
Diagnosis
Investigations available to determine the cause of cor pulmonale include the following:[1]
- Chest x-ray – right ventricular hypertrophy, right atrial dilatation, prominent pulmonary artery
- ECG – right ventricular hypertrophy, dysrhythmia, P pulmonale (characteristic peaked P wave)
- antithrombin III, homocysteinelevels)
Differential diagnosis
The diagnosis of pulmonary heart disease is not easy as both lung and
- Atrial myxoma
- Congestive heart failure
- Constrictive pericarditis
- Infiltrative cardiomyopathies
- Right heart failure(right ventricular infarction)
- Ventricular septal defect
Treatment
The treatment for cor pulmonale can include the following:
Treatment requires
Anticoagulants are used when venous
Epidemiology
The epidemiology of pulmonary heart disease (cor pulmonale) accounts for 7% of all heart disease in the U.S
See also
References
- ^ a b c d e f g h "Cor Pulmonale. Pulmonary heart disease information. Patient | Patient". Patient. Retrieved 2015-12-22.
- ^ a b c d e f g h i "Cor pulmonale: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-12-21.
- ^ PMID 26603978.
- PMID 17060398.
- PMID 19924277.
- ^ "Types of Cardiomyopathy - NHLBI, NIH". www.nhlbi.nih.gov. Retrieved 2015-12-22.
- ISBN 9780781752732.
- ^ "Cor Pulmonale".
- ^ "Blood clots: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-12-22.
- ISBN 9781608316229.
- ISBN 9780781778992.
- ISBN 9781594547928.
- ISBN 9780781746434.
- PMID 23662190.
- ^ a b "Cor Pulmonale: Introduction to Cor Pulmonale, Etiology and Pathophysiology of Cor Pulmonale, Epidemiology of Cor Pulmonale". 2018-11-16.
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(help) - ISBN 9780781752732.
- PMID 31643176. Retrieved 2015-12-22.
- ^ "Calcium channel blockers are not recommended for the treatment of cor pulmonale. | NICE". www.nice.org.uk. Archived from the original on 2015-12-23. Retrieved 2015-12-22.
- PMID 12527688.
Further reading
- Forfia, Paul R.; Vaidya, Anjali; Wiegers, Susan E. (2013-01-01). "Pulmonary heart disease: The heart-lung interaction and its impact on patient phenotypes". Pulmonary Circulation. 3 (1): 5–19. PMID 23662171.
- Taussig, Lynn M.; Landau, Louis I. (2008-04-09). Pediatric Respiratory Medicine. Elsevier Health Sciences. ISBN 978-0323070720.
- Jamal, K.; Fleetham, J. A.; Thurlbeck, W. M. (1990-05-01). "Cor Pulmonale: Correlation with Central Airway Lesions, Peripheral Airway Lesions, Emphysema, and Control of Breathing". American Review of Respiratory Disease. 141 (5_pt_1): 1172–1177. PMID 2339840.