FN: Cor Pulmonale Flashcards Preview

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Flashcards in FN: Cor Pulmonale Deck (13):
1

Definition

RHF due to chronic PHT

2

Symptoms

- Dyspnoea
- Fatigue
- Syncope

3

Signs

1. ↑ JVP ̄c prominent a wave 2. Left parasternal heave
3. LoudP2±S3 4. Murmurs
􏰀 PR: Graham Steell EDM
􏰀 TR: PSM
5. Pulsatile hepatomegaly
6. Fluid: Ascites + Peripheral oedema

4

Investigations bloods

FBC
U&E
LFTs
ESR
ANA
RF

5

ABG shows

Hypoxia ± hypercapnia

6

CXR

􏰁 Enlarged R atrium and ventricle 􏰁 Prominent pulmonary arteries
􏰁 Peripheral oligaemia

7

ECG

P Pulmonale + RVH

8

Echo

RVH
TR
Increase PA pressure

9

Special investigations

Spirometry
Right heart catherisation

10

Management

Treat underlying condition
Reduced pulmonary vascular resistance
Cardiac failure
Heart-lung treatment

11

Reducing vascular resistance

􏰁 LTOT
􏰁 CCB: e.g. nifedipine
􏰁 Sildenafil (PDE-5 inhibitor)
􏰁 Prostacycline analogues
􏰁 Bosentan (endothelin receptor antagonist)

12

Cardiac failure

􏰁 ACEi + β-B (caution if asthma) 􏰁 Diuretics

13

Prognosis

50% at 5 yrs

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