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Cor Pulmonale: Etiology, Symptoms, Diagnostics, Treatment
Cor Pulmonale
Cor pulmonale is a cardiac ailment in which the right side of the heart fails. Long-term elevated blood pressure in the lungs arteries and the hearts right ventricle can result in cor pulmonale (Penn Medicine, n.d.). Right-sided heart failure and pulmonary heart disease are alternative terms.
Etiology
Pulmonary hypertension refers to high blood pressure in the lungs arteries; It is the leading cause of cor pulmonale. Changes in the small blood arteries inside the lungs in persons with pulmonary hypertension can cause an increase in blood pressure on the right side of the heart (Pen Medicine, n.d.). If the high pressure persists, it strains the right side of the heart, which can lead to cor pulmonale.
Symptoms
Symptoms may include (most commonly) exertional dyspnea, tiredness, lethargy, exertional syncope and chest discomfort, abdominal edema or distension, and lower extremity edema (Garrison et al., 2021). The clinical indications appear late in the diseases progression, after the onset of pulmonary hypertension.
Diagnostics
Laboratory examinations are aimed at identifying potential underlying etiologies and assessing the consequences of cor pulmonale (Garrison et al., 2021). Chest radiograph, ECG, doppler echocardiography, chest CT angiography, ventilation/perfusion (V/Q) scans, MRI, PFTs, and 6-minute walk are among them.
Treatment
The primary goal of treatment is to address the underlying problem; the goal is to improve oxygenation and right ventricular (RV) function by enhancing RV contractility and lowering pulmonary vasoconstriction (Garrison et al., 2021). Oxygen treatment reduces hypoxemic pulmonary vasoconstriction, increases cardiac output, decreases sympathetic vasoconstriction, reduces tissue hypoxemia, and enhances renal perfusion. In individuals with chronic cor pulmonale, diuretics reduce the high right ventricular (RV) filling volume (Garrison et al., 2021). Consequently, cardiac glycosides such as digitalis in individuals with cor pulmonale have been contentious (Garrison et al., 2021). Nonetheless, the therapeutic impact of these medicines is not as clear as it is in patients with left heart failure.
References
Garrison, D. M., Pendela, V. S., & Memon, J. (2021). Cor pulmonale. National Library of Medicine. Web.
Pen Medicine. (n.d.). Cor pulmonale (right-sided heart failure). Web.
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