Pulmonary heart disease

Source: Wikipedia, the free encyclopedia.
Pulmonary heart disease
Other namesCor pulmonale
Right ventricular hypertrophy
SpecialtyPulmonology
SymptomsCyanosis, wheezing[1]
CausesPrimary pulmonary hypertension[2]
Diagnostic methodEKG, Thrombophilia screen[1]
TreatmentVasodilators, 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

acute pulmonary heart disease usually results in dilatation.[5] Hypertrophy is an adaptive response to a long-term increase in pressure. Individual muscle cells grow larger (in thickness) and change to drive the increased contractile force required to move the blood against greater resistance. Dilatation is a stretching (in length) of the ventricle in response to acute increased pressure.[6]

To be classified as pulmonary heart disease, the cause must originate in the

lungs risk following and vice versa.[citation needed
]

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

hepatic vein.[7][8] As pulmonary heart disease progresses, most individuals will develop symptoms like:[1]

Causes

Blood clot[9]

The causes of pulmonary heart disease (cor pulmonale) are the following:

Pathophysiology

The pathophysiology of pulmonary heart disease (cor pulmonale) has always indicated that an increase in right ventricular afterload causes RV failure (pulmonary

blood viscosity are usually involved[1]), however most of the time, the right ventricle adjusts to an overload in chronic pressure. According to Voelkel, et al., pressure overload is the initial step for changes in RV, other factors include:[14]

Diagnosis

Normal heart (left) and right ventricular hypertrophy (right)

Investigations available to determine the cause of cor pulmonale include the following:[1]

P pulmonale

Differential diagnosis

The diagnosis of pulmonary heart disease is not easy as both lung and

heart disease can produce similar symptoms. Therefore, the differential diagnosis (DDx) should assess:[15]

Treatment

The treatment for cor pulmonale can include the following:

anticoagulants. Some studies have indicated that Shenmai injection with conventional treatment is safe and effective for cor pulmonale (chronic).[3]

Treatment requires

calcium channel blockers are used[17] but only work in few cases and according to NICE are not recommended for use at all.[18]

Anticoagulants are used when venous

hypoxia), which improves symptoms though survival rate has not been proven to increase. Finally, transplantation of single/double lung in extreme cases of cor pulmonale is also an option.[1]

Epidemiology

The epidemiology of pulmonary heart disease (cor pulmonale) accounts for 7% of all heart disease in the U.S

See also

References

  1. ^ a b c d e f g h "Cor Pulmonale. Pulmonary heart disease information. Patient | Patient". Patient. Retrieved 2015-12-22.
  2. ^ a b c d e f g h i "Cor pulmonale: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-12-21.
  3. ^
    PMID 26603978
    .
  4. .
  5. .
  6. ^ "Types of Cardiomyopathy - NHLBI, NIH". www.nhlbi.nih.gov. Retrieved 2015-12-22.
  7. .
  8. ^ "Cor Pulmonale".
  9. ^ "Blood clots: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-12-22.
  10. .
  11. .
  12. .
  13. .
  14. .
  15. ^ a b "Cor Pulmonale: Introduction to Cor Pulmonale, Etiology and Pathophysiology of Cor Pulmonale, Epidemiology of Cor Pulmonale". 2018-11-16. {{cite journal}}: Cite journal requires |journal= (help)
  16. .
  17. . Retrieved 2015-12-22.
  18. ^ "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.
  19. PMID 12527688
    .

Further reading

External links