II. Pathophysiology

  1. Right ventricular enlargement from primary lung disease
  2. Results in Right Ventricular Hypertrophy
  3. Eventually leads to right ventricular failure

III. Causes

IV. Symptoms

  1. Retrosternal Chest Pain
  2. Cough
  3. Dyspnea
  4. Fatigue
  5. Sputum production

V. 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

VI. Differential Diagnosis (Non-pulmonary disease)

  1. Mitral Stenosis
  2. Left to right cardiac shunts

VIII. 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

IX. 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

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Ontology: Cor pulmonale (C0034072)

Definition (MSHCZE) Hypertrofie a rozšíření pravé srdeční komory je způsobeno plicní hypertenzí. Tento stav je často spojen s plicním parenchymálním nebo vaskulárním onemocněním, jako např. PLICNÍ NEMOC CHRONICKÁ OBSTRUKČNÍ a PLICNÍ EMBOLIE.
Definition (CSP) heart disease due to pulmonary hypertension secondary to disease of the lungs, or its blood vessels, with hypertrophy of the right ventricle.
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.
Concepts Disease or Syndrome (T047)
MSH D011660
ICD10 I27.9 , I27.81
SnomedCT 83291003, 286952009, 155323004, 194879006, 266294009, 155329000, 274096000
English Cor Pulmonale, Disease, Pulmonary Heart, Diseases, Pulmonary Heart, Heart Disease, Pulmonary, Heart Diseases, Pulmonary, Pulmonary Heart Disease, Pulmonary Heart Diseases, COR PULMONALE, Pulmonary heart disease, unspecified, cardiopulmonary disease, DISEASES PULM HEART, PULM HEART DISEASES, HEART DIS PULM, HEART DISEASES PULM, PULM HEART DIS, DIS PULM HEART, Pulmonary heart disease NOS, cor pulmonale (diagnosis), cor pulmonale, Cor pulmonale NOS, Disease heart pulmonary, Heart disease pulmonary, Pulmonary Heart Disease [Disease/Finding], Disease;heart;pulmonary, cardiopulmonary diseases, disease heart pulmonary, heart pulmonary disease, Right heart failure due to disorder of lung, Right heart failure due to pulmonary disease, pulmonary heart diseases, pulmonary heart diseases (diagnosis), Pulmonary heart disease NOS (disorder), Pulmonary circulation diseases (& [heart]), Pulmonary circulation diseases (& [heart]) (disorder), Heart disease - pulmonary, Pulmonary heart disease, Cor pulmonale (disorder), Pulmonary heart disease (disorder), cor; pulmonale, disease (or disorder); cardiopulmonary, disease (or disorder); heart, pulmonary, disease (or disorder); pulmonary, heart disease, pulmonale; cor, Cor pulmonale, pulmonary heart disease
French COEUR PULMONAIRE, Coeur pulmonaire SAI, Syndrome de coeur pulmonaire, Coeur pulmonaire
Portuguese COR PULMONALE, Doença cardiopulmonar, Coração pulmonar NE, Coração pulmonar, Cor Pulmonale, Doença Cardiopulmonar
Spanish COR PULMONALE, Cor pulmonale NEOM, Enfermedad del corazón pulmonar, Cardiopatía pulmonar, corazón pulmonar (trastorno), cor pulmonale (trastorno), cor pulmonale, corazón pulmonar, enfermedad cardiopulmonar, SAI, enfermedad cardiopulmonar, SAI (trastorno), cardiopatía pulmonar, enfermedad cardiopulmonar (trastorno), enfermedad cardiopulmonar, Cor pulmonale, Cor Pulmonale, Enfermedad Cardiopulmonar
Dutch hart- en longziekte, cor pulmonale NAO, aandoening; cardiopulmonaal, aandoening; hart, pulmonaal, aandoening; pulmonaal, hartziekte, cor; pulmonale, pulmonale; cor, Pulmonale hartziekte, niet gespecificeerd, cor pulmonale, Cor pulmonale, Hartziekte, pulmonale, Pulmonale hartziekte
German Emphysemherz, Cor pulmonale NNB, COR PULMONALE, Pulmonale Herzkrankheit, nicht naeher bezeichnet, Cor pulmonale, Pulmonale Herzkrankheit
Italian Cuore polmonare NAS, Cardiopatia polmonare, Cuore polmonare
Japanese 肺性心NOS, ハイセイシンシッカン, ハイセイシンNOS, ハイセイシン, 肺心症, 肺性心, 肺性心疾患
Swedish Lung-hjärtsjukdom
Czech cor pulmonale, srdce plicní, Cor pulmonale, Cor pulmonale NOS
Finnish Keuhkosydänsairaus
Russian LEGOCHNOE SERDTSE, KARDIOPUL'MONAL'NYI SINDROM, КАРДИОПУЛЬМОНАЛЬНЫЙ СИНДРОМ, ЛЕГОЧНОЕ СЕРДЦЕ
Korean 상세불명의 폐성 심장병
Croatian PLUĆNA BOLEST SRCA
Polish Zespół płucno-sercowy, Serce płucne
Hungarian Pulmonalis szívbetegség, Cor pulmonale k.m.n., Cardiopulmonalis betegség, Cor pulmonale
Norwegian Pulmonal hjertesykdom, Cor pulmonale