//fpnotebook.com/
Cor Pulmonale
Aka: Cor Pulmonale
- Pathophysiology
- Right ventricular enlargement from primary lung disease
- Results in Right Ventricular Hypertrophy
- Eventually leads to Right Ventricular Failure
- Causes
- See Respiratory Causes of Pulmonary Hypertension
- Symptoms
- Retrosternal Chest Pain
- Cough
- Dyspnea
- Fatigue
- Sputum production
- Signs
- Tachycardia
- Cyanosis
- Finger Clubbing
- Accentuated right ventricle precordial thrust
- Along left sternal border
- Accentuated and Split pulmonic heart sound (P2)
- Right sided S4 Heart Sound
- Right Sided Heart Failure signs
- Kussmaul's Sign
- Distention of jugular neck veins on inspiration
- Pulsus Paradoxus
- Exaggerated fall in Blood Pressure on inspiration
- Jugular Vein Distention
- Hepatomegaly with Ascites
- Pedal edema
- Differential Diagnosis (Non-pulmonary disease)
- Mitral Stenosis
- Left to right cardiac shunts
- Labs
- Complete Blood Count
- Erythrocytosis
- Electrocardiogram
- Right Ventricular Hypertrophy
- Pulmonary Function Tests
- Arterial Blood Gas
- Radiology
- Chest XRay
- Enlarged pulmonary artery
- Dilated right ventricle
- Primary Pulmonary Hypertension signs
- Tapering of pulmonary artery branches
- Echocardiogram
- Right Ventricular Hypertrophy
- VQ Scan (Radionuclide Lung Scan)
- Evaluate suspected recurrent Pulmonary Embolism
- Management
- Pulmonary therapies
- Bronchodilators
- Oxygen
- Antibiotics when indicated
- Right Ventricular Failure
- Low Sodium diet
- Diuretics
- Digoxin (Use with caution)
- Chronic Anticoagulation on Coumadin
- Arrhythmias: Treat Supraventricular Tachyarrhythmias
- Digoxin
- Quinidine
- Verapamil
- Avoid Beta-Blockers
- References
- Palevsky (1990) JAMA 263:2347-53 [PubMed]