Cor pulmonale Flashcards
1
Q
Define cor pulmonale
A
Impairment of the RV resulting in increased resistance to blood flow in the pulmonary circulation.
Usually as a result of a respiratory disease. Characterised by an increase in the RV size
2
Q
Causes of cor pulmonale
A
Acute respiratory distress syndrome (ARDS) COPD Primary pulmonary hypertension Pulmonary embolism Kyphoscoliosis Interstitial lung disease Cystic fibrosis Sarcoidosis Obstructive sleep apnea (untreated) Sickle cell anemia ( increased blood viscosity) Bronchopulmonary dysplasia
3
Q
Symptoms of Cor Pulmonale
A
Worsening tachypnoea
Fatigue
Ankle swelling
SOBOE
Angina type chest pain
Haemoptysis (if there is a pulmonary arteriole rupture)
Hoarsness (due to compression of the left recurrent laryngeal nerve by dilated pulmonary artery
4
Q
Signs of Cor Pulmonale
A
Cyanosis Hyper-inflated chest (barrel's chest) Decreased air entry, wheezing, crackling (underlying pulmonary pathology) Systolic bruits over lung fields Left parasternal heave (RVH) JVP S3/S4. PSM over tricuspid valve (regurgitation) Hepatomegaly Jaundice, Ascites (in advanced cases) Peripheral pitting oedema
5
Q
Investigations to order
A
Continuous wave Doppler echocardiogram -to assess right ventricular systolic pressure Pulsed wave Doppler echocardiogram - to estimate the pulmonary arterial pressure Spirometry/Lung function tests CXR/CT/MRI of chest Bronchoscopy Lung biopsy ECG FBC, BNP ABG Alpha-1 Antitrypsin (In COPD patient) Thrombophilia screen
6
Q
Treatment for Cor Pulmonale
A
Diuretics- Furosemide/Bumetanide Vasodilator: Nifedipine or Diltiazem Methylxanthine bronchodilator (theophylline) Long term oxygen therapy Anticoagulation
