Right sided Heart failure

Question 1

What causes cor pulmonale (pathophysiology)?

Answer 1

It is right sided heart failure due to respiratory disease.
Hypertension in the pulmonary arteries means that the heart is unable to pump effectively so there is a backlog into the right atrium, vena cava and the systemic venous system.

Question 2

What are the most common causes?

Answer 2

COPD (most common).
PE.
Cystic fibrosis.
Interstitial lung disease (sarcoidosis, coal workers pneumoconiosis).

Question 3

What presentations usually occur with Cor Pulmonale?

Answer 3

Often patients are asymptomatic, however there can be progressive shortness of breath. Patients often present with peripheral oedema and syncope. 
Raised JVP (due to backlog of blood in the venous system).

Question 4

How do you treat Cor Pulmonale?

Answer 4

Treat the underlying cause.