Cardiovascular Medicine Book

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Cor Pulmonale

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  1. Pathophysiology
    1. Right ventricular enlargement from primary lung disease
    2. Results in Right Ventricular Hypertrophy
    3. Eventually leads to right ventricular failure
  2. Causes
    1. See Respiratory Causes of Pulmonary Hypertension
  3. Symptoms
    1. Retrosternal Chest Pain
    2. Cough
    3. Dyspnea
    4. Fatigue
    5. Sputum production
  4. Signs
    1. Tachycardia
    2. Cyanosis
    3. Finger Clubbing
    4. Accentuated right ventricle precordial thrust
      1. Along left sternal border
    5. Accentuated and Split pulmonic heart sound (P2)
    6. Right sided S4 Heart Sound
    7. Right Sided Heart Failure signs
      1. Kussmaul's Sign
        1. Distention of jugular neck veins on inspiration
      2. Pulsus Paradoxus
        1. Exaggerated fall in Blood Pressure on inspiration
      3. Jugular Vein Distention
      4. Hepatomegaly with Ascites
      5. Pedal edema
  5. Differential Diagnosis (Non-pulmonary disease)
    1. Mitral Stenosis
    2. Left to right cardiac shunts
  6. Labs
    1. Complete Blood Count
      1. Erythrocytosis
    2. Electrocardiogram
      1. Right Ventricular Hypertrophy
    3. Pulmonary Function Tests
    4. Arterial Blood Gas
  7. Radiology
    1. Chest XRay
      1. Enlarged pulmonary artery
      2. Dilated right ventricle
      3. Primary Pulmonary Hypertension signs
        1. Tapering of pulmonary artery branches
    2. Echocardiogram
      1. Right Ventricular Hypertrophy
    3. VQ Scan (Radionuclide Lung Scan)
      1. Evaluate suspected recurrent Pulmonary Embolism
  8. Management
    1. Pulmonary therapies
      1. Bronchodilators
      2. Oxygen
      3. Antibiotics when indicated
    2. Right Ventricular Failure
      1. Low sodium diet
      2. Diuretics
      3. Digoxin (Use with caution)
      4. Chronic Anticoagulation on Coumadin
    3. Arrhythmias: Treat Supraventricular Tachyarrhythmias
      1. Digoxin
      2. Quinidine
      3. Verapamil
      4. Avoid Beta-Blockers
  9. References
    1. Palevsky (1990) JAMA 263:2347

Cor pulmonale (C0034072)

Definition (MSH)Hypertrophy and dilation of the RIGHT VENTRICLE of the heart that is caused by PULMONARY HYPERTENSION. This condition is often associated with pulmonary parenchymal or vascular diseases, such as CHRONIC OBSTRUCTIVE PULMONARY DISEASE and PULMONARY EMBOLISM.
Definition (CSP)heart disease due to pulmonary hypertension secondary to disease of the lungs, or its blood vessels, with hypertrophy of the right ventricle.
ConceptsDisease or Syndrome (T047)
ICD9416.9
MSHD011660
BasqueBIHOTZ BIRIKAZKO KRONIKOA
DanishPulmonal hjertesygdom
DutchCor pulmonale
Englishcardiopulmonary disease, Cor pulmonale, DIS PULM HEART, DISEASE HEART PULMONARY, DISEASES PULM HEART, HEART DIS PULM, Heart disease - pulmonary, HEART DISEASE PULMONARY, HEART DISEASES PULM, PULM HEART DIS, PULM HEART DISEASES, Pulmonary Heart Disease, Pulmonary Heart Diseases
FinnishKEUHKOPERAINEN SYDANTAUTI
FrenchCoeur pulmonaire chronique
GermanCor pulmonale/Rechtsherzbelastung
Hebrewmaxalat lev reatit
Hungariancor pulmonale
ItalianCuore polmonare cronico
NorwegianPULMONAL HJERTESYKDOM
PortugueseDoenca pulmonar cardiaca
Spanishcardiopatia pulmonar, cor pulmonale, corazon pulmonar, enfermedad cardiopulmonar, Enfermedad pulmonar cardiaca
SwedishCOR PULMONALE/HOGERKAMMARSVIKT
Parent ConceptsHeart failure (C0018801), Heart Diseases (C0018799), pulmonary circulation obstruction (C0597323), Vascular abnormalities (C0241657), Cardiac Disorders, General, Functional and NEC (C0549515), Respiratory System Disorders, General, Functional and NEC (C0549576), HEART: MUSCLE/VALVE (C0549605), circulatory system (C0497231), Diagnosis/Diseases Component (C0497531), Cor pulmonale (C0034072), Pulmonary circulation disease NOS (C0178272), Ambiguous concept (C1274012), Duplicate concept (C1274013)
SourcesAOD, CCS, COSTAR, CSP, CST, DXP, ICPC, ICPCBAQ, ICPCDAN, ICPCDUT, ICPCFIN, ICPCFRE, ICPCGER, ICPCHEB, ICPCHUN, ICPCITA, ICPCNOR, ICPCPOR, ICPCSPA, ICPCSWE, MSH, MTH, MTHICD9, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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