1. kinghamada

    kinghamada Guest

    This is a discussion of Cor Pulmonale regarding its definition, causes, clinical picture, investigations and treatment .
    What is meant by Cor Pulmonale ?

    It is a right ventricular hypertrophy due to parenchymal lung disease, vascular lung disease or chest wall disease with or without right sided heart failure. So, there is secondary pulmonary hypertension due to the following causes.
    cor-pulmonale.jpg

    Causes of Cor Pulmonale ?

    1) Parenchymal lung diseases ===> Hypoxia.
    a. Chronic obstructive pulmonary disease. (chronic bronchitis/emphysema)
    b. Interstitial lung fibrosis
    2) Vascular lung diseases
    a. Bilharzial cor pulmonale
    b. Thromboembolic P++ (subacute cor Pulmonale)
    3) Chest wall diseases e.g. Kyphoscliosis===> hypoventilation ===> hypoxia.
    4) Disturbance in respiratory control
    • Morbid obesity (pickwickian$)
    • Sleep apnoea. Both lead to Hypoxia
    Hypoxia ===> pulmonary arteriolar vasoconstriction ===> pulmonary hypertension.
    Clinical picture

    1) Clinical picture of the Cause
    2) Right ventricular++, pulmonary hypertension
    3) Right ventricular failure .
    Investigations to diagnose Cor Pulmonale

    • ECG may be normal with emphysema or there is decreased
     
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