Pulmonary heart disease , also known as cor pulmonale , is the enlargement and failure of the right ventricle of the heart in response to increased vascular resistance (such as from pulmonary stenosis) or high- lungs.
Chronic pulmonary heart disease usually causes right ventricular hypertrophy (RVH), whereas acute pulmonary heart disease usually causes dilatation. Hypertrophy is an adaptive response to increased long-term pressure. Individual muscle cells grow larger (in thickness) and change to encourage the increased contractile force necessary to move blood against greater resistance. Dilation is the ventricular (length) stretching in response to an increase in acute pressure.
To be classified as pulmonary heart disease, the cause must originate from the pulmonary circulatory system. Two causes are vascular changes as a result of tissue damage (eg disease, hypoxic injury), and chronic hypoxic pulmonary vasoconstriction. If left untreated, then death may occur, RVH because systemic defects are not classified as pulmonary heart disease. The heart and lungs are closely related; every time the heart is affected by the disease, the lungs are at risk following and vice versa.
Video Pulmonary heart disease
Signs and symptoms
Symptoms of pulmonary heart disease may become non-specific and depend on the stage of the disorder, and may include blood buildup into the systemic venous system, including the hepatic vein. As the development of pulmonary heart disease, most individuals will experience symptoms such as:
Maps Pulmonary heart disease
Cause
The cause of pulmonary heart disease (cor pulmonale) is as follows:
Pathophysiology
The pathophysiology of pulmonary heart disease always indicates that an increase in right ventricular afterload causes RV failure (pulmonary vasoconstriction, pulmonary vascular anatomy/bedside disorders and increased blood viscosity usually involved), but most of the time, the right ventricle adjusts to the excess burden on the pressure chronic. According to Voelkel, et al., Excessive pressure is the first step to change in RV, other factors include:
Diagnosis
The available investigations to determine the cause of cor pulmonale include the following:
- Chest X-rays - right ventricular hypertrophy, right atrial dilatation, prominent pulmonary artery
- ECG - right ventricular hypertrophy, dysrhythmia, P pulmonale (characteristic of peak P wave)
- Thrombophilia screen - to detect chronic venous thromboembolism (proteins C and S, antithrombin III, homocysteine ​​levels)
Differential diagnosis
Diagnosis of pulmonary heart disease is not easy because the lungs and heart disease can produce the same symptoms. Therefore, the differential diagnosis should assess:
Treatment
Treatments for cor pulmonale may include: antibiotics, expectorants, oxygen therapy, diuretics, digitalis, vasodilators, and anticoagulants. Several studies have shown that Shenmai injection with conventional treatment is safe and effective for cor pulmonale (chronic).
Treatment requires diuretics (to reduce the pressure on the heart). Oxygen is often needed to overcome shortness of breath. In addition, oxygen to the lungs also helps relax the blood vessels and reduce heart failure right. When wheezing is present, most individuals require bronchodilators. Various drugs have been developed to relax the blood vessels in the lungs, calcium channel blockers are used but only work in some cases and according to NICE is not recommended for use at all.
Anticoagulants are used when venous thromboembolism is present. Venesection is used in severe secondary polycythemia (due to hypoxia), which improves symptoms although survival rates have not been shown to increase. Finally, single/double lung transplantation in extreme cases of the pulmonary corpus is also an option.
Epidemiology
Epidemiology of pulmonary heart disease accounts for 7% of all heart disease in the US According to Weitzenblum, et al., Deaths associated with cor pulmonale are not easy to ascertain, as they are a complication of COPD.
See also
- Bilharzial cor pulmonale.
References
Further reading
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Forfia, Paul R.; Vaidya, Anjali; Wiegers, Susan E. (2013-01-01). "Pulmonary heart disease: Heart-lung interaction and its impact on the patient phenotype". Lung circulation . 3 (1): 5-19. doi: 10.4103/2045-8932.109910. ISSN 2045-8932. PMC 3641739 . PMID 23662171. - Taussig, Lynn M.; Landau, Louis I. (2008-04-09). Pediatric Respiratory Medicine . Health Sciences Elsevier. ISBN: 0323070728. Ã,
- Jamal, K.; Fleetham, J. A.; Thurlbeck, W. M. (1990-05-01). "Cor Pulmonale: Correlation with Central Airway Lesions, Air Peripheral Lesions, Emphysema, and Respiratory Control". American Review of Respiratory Disease . 141 (5_pt_1): 1172-1177. doi: 10.1164/ajrccm/141.5_Pt_1.1172. ISSNÃ, 0003-0805. Ã,
External links
Source of the article : Wikipedia
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