Cor pulmonale symptoms, diagnosis and treatment

What is Cor pulmonale :

Cor pulmonale is a heart disease in which an alteration in the structure and function of the right heart (right ventricle) as a result of an increase in pressure in the pulmonary circulation (pulmonary hypertension).

Any disease cardio-respiratory system causing pulmonary hypertension resulting in extra work on the right side of the heart can cause cor pulmonale.

How does it occur ?

Normally the right heart is responsible for receiving a large volume of blood is oxygenated and has thin walls and distensible to suit the amount received. The blood reaching the right heart is pumped by the right ventricle and the pulmonary artery to the lungs to pick up oxygen.

When a lung disease or pulmonary circulation (pulmonary artery) is an increase of pressure (PH) has the right heart to pump blood difficulties because their thin walls can not counter this increased resistance and failure occurs in its operation. Consequently, the right ventricular volume increases (dilation) and thick (hypertrophy). It creates a situation of right heart failure leading to a prolonged decrease in oxygen supply to the blood.

Cor pulmonale may be secondary to a variety of cardiopulmonary diseases. May occur after acute lung disease or pulmonary embolism, much more frequent, be the result of chronic lung disease (cor pulmonale).

The most frequent cause of cor pulmonale is chronic obstructive pulmonary disease (COPD) but any lung disease can cause cor pulmonale as asthma, cystic fibrosis, sleep apnea or primary pulmonary hypertension, among others.

Cor pulmonale Symptoms

Own symptoms of lung disease that is caused, for example, chronic cough, dyspnea or shortness of breath, etc..

Other symptoms are due to right heart malfunction that manifests as a buildup of fluid in the legs (edema) and abdomen (ascites), enlarged liver (hepatomegaly) and dilated neck veins. These symptoms are more evident as the disease progresses.

Cor pulmonale Diagnosis

The diagnosis of cor pulmonale is based on the patient’s medical record that allows an underlying suspicion along with a series of tests that help confirm right heart failure.

• Recording the electrocardiogram may be suggestive of increased right heart chambers and pulmonary hypertension.
• Arterial blood gas analysis indicates the level of blood oxygenation.
• Imaging tests such as echocardiography, CT and MRI allow you to view the structure of the heart and lungs and determine the causes of cor pulmonale and the degree of cardiopulmonary impairment.
• Ventilation-perfusion scintigraphy is a test that is used mainly in pulmonary embolism to view the affected lung zones.
• Cardiac catheterization is a test that measures the pressure in the right heart chambers and pulmonary artery verifying the diagnosis.

Cor pulmonale Treatment

Treatment is aimed at treating the cause of the disease that is causing cor pulmonale and to improve oxygenation and right ventricular function. The most serious problem is pulmonary hypertension. In many cases, the disease that causes hypertension is so advanced that there are few effective treatments.

• Drugs used to treat the underlying disease: for example if there is a thromboembolism anticoagulants or bronchodilators in chronic bronchitis.
• Treatment to relieve symptoms caused by the failure of the right ventricle: for fluid accumulation using diuretics, drugs to improve ventricular function and reduce pulmonary artery pressure and systemic (vasodilators).
• Low-salt diet.
• Administration of oxygen.
• In selected cases, ultimately lung transplantation or heart-lung transplant may be the only alternative curative treatment.

Cor pulmonale Prevention

The most common cause of chronic cor pulmonale is COPD. Smoking is the most common cause of COPD, therefore, not smoking will prevent the onset of chronic lung diseases and the development of cor pulmonale.