cor pulmonale

Question 1

What is pulmonary hypertension?

Answer 1

It is elevated mean pulmonary arterial pressure in the arteries that exceeds >25mmHg at rest due to chronic pulmonary or cardiac disease

Question 2

What is cor pulmoanle?

Answer 2

Right ventricular hypertrophy or dilation or impaired function of the right ventricle that is caused by pulmonary hypertension

Question 3

How does acute pulmonary embolism present?

Answer 3

1. Sudden overloading of the right ventricle usually due o pulmonary embolism which is life threatening

Question 4

How does chronic cor pulmonale occur?

Answer 4

It is the mos common form and slowly progresses

Question 5

What are the causes of cor pulmonale?

Answer 5

1. COPD
2. Chronic sleep apnea
3. pulmonary embolism
   4.

Question 6

What is the pathophysiology of cor pulmonale and how it causes death?

Answer 6

1. There’s increased pressure in the pulmonary circuit which leads to right ventricular afterload and dilatation and hypertrophy and subsequent right heart failure and arrythmias

Question 7

What is the classification of pulmonary hypertension?

Answer 7

• Group 1: pulmonary arterial hypetension
• Group 2: pulmonary due left sided heart failure
• Group 3: pulmonary hypertension due to lun diseases/or hypoxia
• Group 4: Chronic thromboembolic pulmonary hypertension

Question 8

What are the symptoms of pulmonary hypertension?

Answer 8

1. fatigue
2. dyspnea and syncope on exertion because of the decreased cardiac output because of the pulmonary vascular resistance
3. cyanosis and cold peripheries
4. chest pain
5. hoarseness

Question 9

What are the clinical features they present with on physical exam?

Answer 9

1. Loud and palpable P2
2. Parasternal heave
3. raised JVP
4. Right heart failure: oedema, ascites, fatigue, hepatosplenomegaly, hepatojugular reflux

Question 10

What special investigations do we do in cor pulmonale

Answer 10

1. echocardiogram: which will show right ventricular hypertrophy and dilation
2. ECG which will show right axis deviation indicating right ventricular hypertrophy
3. right heart catheterisation
4. chest X-ray: right heart hypertrohy

Question 11

What is the treatment of pulmonary hypertension?

Answer 11

1. Supplemental oxygen
2. Diuretics
3. calcium channel blockers(vasodilator)
4. long acting proastacyclin which vasodilates
5. Phosphodiesterase 5 Inhibitors like sildenafil