Cor Pulmonale

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Introduction

Cor pulmonale, also known as pulmonary hypertensive heart disease, is characterized by right ventricular hypertrophy, dilation, and potential failure. It is caused by pulmonary hypertension, which follows a variety of disorders.

 

 

 

The Case of...

a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.

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Causes and Risk Factors

Diseases of the lung parenchyma

Diseases of pulmonary vessels

Disorders affecting chest movement

Disorders inducing pulmonary arterial constriction

 

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Pathophysiology

 

 

used with permission, wikimedia

The right ventricular dilation following left-sided failure or congenital problems is similar to that of cor pulmonale.

Cor pulmonale can be acute or chronic.

Acute cor pulmonale can follow a massive pulmonary embolism. Marked dilation occurs without hypertrophy.

Chronic cor pulmonale suggests prolonged pressure overload caused by obstruction of pulmonary arteries or arterioles or by destruction of septal capillaries. The right ventricular wall thickens and my even begin to approximate the left ventricle.

Secondary compression of the left ventricular chamber or tricuspid regurgitation can follow fibrous thickening of the valve.

 

 

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Signs and Symptoms

  • history
  • physical exam

History

 

Physical Exam

Signs of right-sided hearted failure include:

  • increased JVP
  • hepatomegaly

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Investigations

  • lab investigations
  • diagnostic imaging

Lab Investigations

Diagnostic Imaging

 

ECG shows:

  • RAD and poor R wave progression
  • RAE with and RVH
  • multifocal atrial tachycardia

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Differential Diagnosis

 

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Treatments

 

 

 

 

Consequences and Course

 

 

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The Case of...

Case #2 - a small story wrapping it all up and asking especially about management.

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Additional Resources

 

 

 

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Topic Development

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