Cor pulmonale

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Reason: Blank Lemma Partynia RM ∞ 16:49, March 8 2014 ( CET )

Cor pulmonale (Latin: " pulmonary heart " ) refers to a pressure -loaded right heart due to an increase in pressure in the pulmonary circulation (pulmonary hypertension or secondary pulmonary hypertension), when their cause is to be found in the lungs, not the heart. This increase in pressure can have various causes, from pulmonary embolism on the chronic obstructive pulmonary disease ( COPD ) to the world -spread worm disease schistosomiasis. This means that the therapeutic possibilities of cor pulmonale are so different that the term used less and less and instead the more modern nomenclature of pulmonary hypertension (see below) is applied.

Molding

A distinction is especially

  • Acute cor pulmonale and
  • Chronic cor pulmonale.

Other allocations are made according to the severity and after the triggering causes.

Causes

A high blood pressure in the pulmonary circulation, the right heart is charged. This pulmonary high pressure by a pulmonary embolism or other lung diseases such as:

  • Emphysema
  • Pulmonary fibrosis
  • Chronic thrombo- embolic pulmonary hypertension induced ( CTEPH )
  • Long-standing chronic obstructive pulmonary disease ( COPD)
  • Pleuraschwarten
  • Kyphoscoliosis
  • Cystic fibrosis

Triggered. The result of the lung disease is an increased resistance of the pulmonary circulation. The increase in resistance is caused by narrowing of the pulmonary arteries or by a reduction and desertification ( rarefaction ) of pulmonary vessels.

It may also be a consequence of stage III sarcoidosis.

Symptoms

In milder cases of chronic pulmonary heart disease symptoms may be absent at rest. Otherwise, the symptom is shortness of breath during exercise or at rest already. Other symptoms may include:

  • Pressure in the chest
  • Central cyanosis
  • Secondary polycythemia
  • Hypertrophic osteoarthropathy
  • Tachycardia
  • Right heart failure
  • Respiratory acidosis
  • In caliber

When severe acute cor pulmonale eg following a pulmonary embolism it comes to respiratory distress, pallor and cyanosis. It occurs circulatory shock, which can lead to a complete right heart failure and death.

Diagnostics

  • Oxygen saturation
  • ECG: " P pulmonale "
  • Abnormal right deviation of the P- vector
  • SI - QIII - layer type
  • Left - shifted R / S transition.
  • Ball type to type right
  • Legal delay in bundle branch block
  • Thickened wall of the right ventricle in the subcostal section
  • Enlargement of the right atrium and the right ventricle
  • Tricuspid regurgitation
  • Jammed hepatic veins
  • Increased pulmonary arterial pressure
  • Resting measurement, strain measurement
  • Detection of thrombi in the pulmonary artery

Therapy

  • Treatment of pulmonary underlying disease
  • Treatment of pulmonary embolism Temporary or permanent anticoagulation
  • Nitrates
  • Diuretics
  • ACE inhibitor
Electrocardiography Tricuspid insufficiency
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