SlideShare a Scribd company logo
COR -
PULMONALE
Presented By:
Mr. Nandish.S
Asso. Professor
Mandya Institute of Nursing Sciences
DEFINITION :
Cor Pulmonale is a Latin word means “pulmonary heart”.
It is defined as an alteration in the structure and function of right
ventricle due to pulmonary hypertension.
It is the enlargement of right ventricle secondary to diseases of lung,
thorax or pulmonary circulation.
It is the failure of right side of Heart caused by prolonged high blood
pressure in the pulmonary artery & right ventricle.
It is also called as right side heart failure.
INCIDENCE & PREVALENCE :
 It accounts for 6 – 7 % of all types of adult heart diseases.
 50% of the cor pulmonale cases are due to Chronic Obstructive
Pulmonary Disease.
 Cor pulmonale varies among other countries depending on factors
like cigarette smoking, air pollution and other lung disorders.
ETIOLOGY :
I. Diseases of the Lung parenchyma :
 Chronic pulmonary obstructive disease
- Emphysema
- Chronic Bronchitis
 Cystic Fibrosis
 Idiopathic Interstitial Pneumonitis
 Sarcoidosis
 Bronchiectasis
 Lymphangioleiomyomatosis
II. Diseases of Pulmonary Vasculature
 Pulmonary Arterial Hypertension (PAH)
1) Idiopathic
2) Heritable
3) Associated
 Veno-occlusive disease
 Chronic thromboembolic pulmonary hypertension
 Pulmonary Tumor thrombotic microangiopathy
III. Disorders of Chronic / Alveolar Hypoxia
 Alveolar Hypoventilation syndromes
 Obesity Hypoventilation syndrome
 Central Hypoventilation syndrome
 Neuromuscular Respiratory Failure
 Chest wall disorders
- Kyphoscoliosis
 Living at High altitude
PATHOPHYSIOLOGY :
Genetic Factors Unknown Factors
Pulmonary Endothelial Injury
Vasoconstriction
Remodelling (Vessel wall thickening)
Sustained Pulmonary Hypertension
Right Ventricular Hypertrophy
Cor Pulmonale
CLINICAL MANIFESTATIONS :
 Dyspnoea
 Chronic productive cough
 Wheezing
 Tachycardia
 Retrosternal or Substernal pain
 Fatigue
 Chronic hypoxemia : it leads to polycythemia & total blood volume.
ADDITIONAL MANIFESTATIONS :
 Peripheral / Ankle edema
 Weight gain
 Distended neck veins / Jugular vein distension
 Bounding pulse
 Hepatomegaly
 Cyanosis
 Exertional Syncope
 Lethargy
 Chronic wet cough
DIAGNOSTIC STUDIES :
 History collection & Physical Examination
 Chest X – Ray
 Pulmonary Function Test
 6 minute walk test
 ECG (inverted T Wave)
 Echocardiogram (right ventricular dilation)
 ABG Analysis
 Chest CT Angiography
 Cardiac catheterization
 Doppler studies (To monitor pulmonary artery pressure)
 MRI (Cardiac Magnetic Resonance)
MANAGEMENT :
It is directed towards treating underlying pulmonary problem that
precipitated heart disorder.
 General Management
 Specific Management
 Management of complication
 Management of acute exacerbation
 Surgical management : Lung Transplantation
GENERAL MANAGEMENT :
 Education & Reassurance
 Oxygen Therapy (long term low flow oxygen)
 Low Level graded Aerobic exercises
 Avoid heavy physical exertion
 Sodium restricted diet ( < 2400 mg / day)
 Routine immunization
 Cessation of smoking
SPECIFIC MANAGEMENT :
 Endothelin receptor antagonist
Ambrisentan, Bosentan, Macitentan
 Prostacyclin (PGI2) Analogues
Epoprostenol – intravenous formulation
Treprostinil – subcutaneous
Iloprost – inhalation
 Phosphodiesterase Type 5 (PDE5) inhibitors
Sildenafil, Tadalafil , Vardenafil
 Calcium Channel blockers
Diltiazem
MANAGEMENT OF COMPLICATION :
Warfarin
 Anticoagulation with warfarin is recommended in patients at high
risk for thromboembolism.
 Recommended dosage is 1.5 to 2.5 as prophylaxis.
Diuretics
 Are used to decrease the elevated right ventricular filling volume in
patients with chronic cor pulmonale.
 A combination of Loop diuretic (Furosemide) and Potassium sparing
diuretic (Spironolactone) is used for better response.
MANAGEMENT OFACUTE EXACERBATION:
 Hospitalization
 Oxygen therapy
 Control of heart failure
 Control of cardiac arrhythmia
 Control of infection
 Treatment of lung disease accordingly.
NURSING DIAGNOSIS :
 Decreased cardiac output related to restricted cardiac muscle
contractility as evidenced by Doppler study finding.
 Impaired gas exchange related to expiratory airflow obstruction as
manifested by reduced oxygen saturation level.
 Impaired tissue perfusion related to decreased cardiac contractility as
manifested by capillary refill time more than 3 seconds.
 Activity intolerance related to laboured respirations as manifested by
difficulty in performing ADL.
 Anxiety related to disease progression as evidenced by patient’s
verbalization & facial expression.
Cor - Pulmonale.pptx

More Related Content

What's hot

Cardiomyopathy
Cardiomyopathy Cardiomyopathy
Cardiomyopathy
SUDESHNA BANERJEE
 
Pulmonary edema by Nadia Sarwar
Pulmonary edema by Nadia SarwarPulmonary edema by Nadia Sarwar
Pulmonary edema by Nadia Sarwar
Nadia Sarwar
 
Cardiomyopathy
CardiomyopathyCardiomyopathy
Cardiomyopathy
Abhay Rajpoot
 
Cardiac tamponade-Pericardial Effusion...
Cardiac tamponade-Pericardial Effusion...Cardiac tamponade-Pericardial Effusion...
Cardiac tamponade-Pericardial Effusion...
Sharmin Susiwala
 
Aneurysm
AneurysmAneurysm
Congestive Heart Failure
Congestive Heart FailureCongestive Heart Failure
Congestive Heart Failure
Salah Nazar
 
Cardiac emergency
Cardiac emergencyCardiac emergency
Cardiac emergency
RijoLijo
 
Valvular heart disease
Valvular heart diseaseValvular heart disease
Valvular heart disease
ramanlal patidar
 
Valvular heart disease
Valvular heart diseaseValvular heart disease
Valvular heart disease
Ratheeshkrishnakripa
 
Acute coronary syndrome
Acute coronary syndromeAcute coronary syndrome
Acute coronary syndromeAparna A
 
Myocarditis
MyocarditisMyocarditis
Myocarditis
saheli chakraborty
 
Pericarditis utkarsh
Pericarditis   utkarshPericarditis   utkarsh
Pericarditis utkarsh
UTKARSHMittal28
 
Myocarditis
MyocarditisMyocarditis
Myocarditis
salman habeeb
 
Pericarditis
PericarditisPericarditis
Pericarditis
Prof Vijayraddi
 
Coronary artery disease
Coronary artery diseaseCoronary artery disease
Coronary artery disease
sonia dagar
 
Inflammatory diseases of heart
Inflammatory diseases of heartInflammatory diseases of heart
Inflammatory diseases of heart
Rajee Ravindran
 

What's hot (20)

Cardiomyopathy
Cardiomyopathy Cardiomyopathy
Cardiomyopathy
 
Pulmonary edema by Nadia Sarwar
Pulmonary edema by Nadia SarwarPulmonary edema by Nadia Sarwar
Pulmonary edema by Nadia Sarwar
 
Cardiomyopathy
CardiomyopathyCardiomyopathy
Cardiomyopathy
 
Cardiac tamponade-Pericardial Effusion...
Cardiac tamponade-Pericardial Effusion...Cardiac tamponade-Pericardial Effusion...
Cardiac tamponade-Pericardial Effusion...
 
Aneurysm
AneurysmAneurysm
Aneurysm
 
Congestive Heart Failure
Congestive Heart FailureCongestive Heart Failure
Congestive Heart Failure
 
Cardiac emergency
Cardiac emergencyCardiac emergency
Cardiac emergency
 
Valvular heart disease
Valvular heart diseaseValvular heart disease
Valvular heart disease
 
Valvular heart disease
Valvular heart diseaseValvular heart disease
Valvular heart disease
 
Coronary Artery Disease
Coronary Artery DiseaseCoronary Artery Disease
Coronary Artery Disease
 
Pulmonary edema
Pulmonary edemaPulmonary edema
Pulmonary edema
 
Acute coronary syndrome
Acute coronary syndromeAcute coronary syndrome
Acute coronary syndrome
 
Myocarditis
MyocarditisMyocarditis
Myocarditis
 
Pericarditis utkarsh
Pericarditis   utkarshPericarditis   utkarsh
Pericarditis utkarsh
 
Myocarditis
MyocarditisMyocarditis
Myocarditis
 
Cardiac emergency ppt
Cardiac emergency pptCardiac emergency ppt
Cardiac emergency ppt
 
Pericarditis
PericarditisPericarditis
Pericarditis
 
heart failure
heart failureheart failure
heart failure
 
Coronary artery disease
Coronary artery diseaseCoronary artery disease
Coronary artery disease
 
Inflammatory diseases of heart
Inflammatory diseases of heartInflammatory diseases of heart
Inflammatory diseases of heart
 

Similar to Cor - Pulmonale.pptx

Cor pulmonale - october'18
Cor pulmonale - october'18Cor pulmonale - october'18
Cor pulmonale - october'18
Dewan Shafiq
 
Cor pulmonale.pptx
Cor pulmonale.pptxCor pulmonale.pptx
Cor pulmonale.pptx
AnmolPrashar5
 
Pulmonary Hypertension and its management
Pulmonary Hypertension and its managementPulmonary Hypertension and its management
Pulmonary Hypertension and its management
Mohit Goyal
 
Pulmonary vascular disease / Pulmoary hypertension
Pulmonary vascular disease / Pulmoary hypertensionPulmonary vascular disease / Pulmoary hypertension
Pulmonary vascular disease / Pulmoary hypertension
Dr. Darayus P. Gazder
 
Respiratory Diseases II
Respiratory Diseases IIRespiratory Diseases II
Respiratory Diseases IIdiamondeye
 
ARDS (acute respiratory distress syndrome) ppt SlideShare
ARDS (acute respiratory distress syndrome) ppt SlideShareARDS (acute respiratory distress syndrome) ppt SlideShare
ARDS (acute respiratory distress syndrome) ppt SlideShare
sonam
 
Cor pulmonaly
Cor pulmonalyCor pulmonaly
Cor pulmonaly
suchismita sethi
 
Pulmonary hypertension
Pulmonary hypertensionPulmonary hypertension
Pulmonary hypertension
Alaa Ateya
 
Pulmonary hypertension
Pulmonary hypertensionPulmonary hypertension
Pulmonary hypertension
mt53y8
 
dyspnea approach
dyspnea approachdyspnea approach
dyspnea approach
Prateek Singh
 
Cor pulmonare
Cor pulmonareCor pulmonare
Cor pulmonare
MedicinaIngles
 
Pulmonary 1ok;;;;;;;;;;ljopppppppppppppppp.pptx
Pulmonary  1ok;;;;;;;;;;ljopppppppppppppppp.pptxPulmonary  1ok;;;;;;;;;;ljopppppppppppppppp.pptx
Pulmonary 1ok;;;;;;;;;;ljopppppppppppppppp.pptx
mousaderhem1
 
Pulmonary Hypertension 1
Pulmonary Hypertension 1Pulmonary Hypertension 1
Pulmonary Hypertension 1
ratliff6275
 
Pulmonary hypertension
Pulmonary  hypertensionPulmonary  hypertension
Pulmonary hypertension
sawsan elsawy
 
Pul hypertension
Pul hypertensionPul hypertension
Pul hypertension
sawsan elsawy
 
Pulmonary hypertension 27 06-19
Pulmonary  hypertension 27 06-19Pulmonary  hypertension 27 06-19
Pulmonary hypertension 27 06-19
GOVIND DESAI
 
8. Respiratory failure in human body.ppt
8. Respiratory failure in human body.ppt8. Respiratory failure in human body.ppt
8. Respiratory failure in human body.ppt
ShinilLenin
 
Dyspnea
DyspneaDyspnea
Dyspnea
cairo1957
 

Similar to Cor - Pulmonale.pptx (20)

Cor pulmonale - october'18
Cor pulmonale - october'18Cor pulmonale - october'18
Cor pulmonale - october'18
 
Cor pulmonale.pptx
Cor pulmonale.pptxCor pulmonale.pptx
Cor pulmonale.pptx
 
Pulmonary Hypertension and its management
Pulmonary Hypertension and its managementPulmonary Hypertension and its management
Pulmonary Hypertension and its management
 
Pulmonary vascular disease / Pulmoary hypertension
Pulmonary vascular disease / Pulmoary hypertensionPulmonary vascular disease / Pulmoary hypertension
Pulmonary vascular disease / Pulmoary hypertension
 
Respiratory Diseases II
Respiratory Diseases IIRespiratory Diseases II
Respiratory Diseases II
 
ARDS (acute respiratory distress syndrome) ppt SlideShare
ARDS (acute respiratory distress syndrome) ppt SlideShareARDS (acute respiratory distress syndrome) ppt SlideShare
ARDS (acute respiratory distress syndrome) ppt SlideShare
 
Cor pulmonaly
Cor pulmonalyCor pulmonaly
Cor pulmonaly
 
Pulmonary hypertension
Pulmonary hypertensionPulmonary hypertension
Pulmonary hypertension
 
Cor pulmonale
Cor pulmonaleCor pulmonale
Cor pulmonale
 
Pulmonary hypertension
Pulmonary hypertensionPulmonary hypertension
Pulmonary hypertension
 
dyspnea approach
dyspnea approachdyspnea approach
dyspnea approach
 
Cor pulmonare
Cor pulmonareCor pulmonare
Cor pulmonare
 
Pulmonary 1ok;;;;;;;;;;ljopppppppppppppppp.pptx
Pulmonary  1ok;;;;;;;;;;ljopppppppppppppppp.pptxPulmonary  1ok;;;;;;;;;;ljopppppppppppppppp.pptx
Pulmonary 1ok;;;;;;;;;;ljopppppppppppppppp.pptx
 
Pulmonary Hypertension 1
Pulmonary Hypertension 1Pulmonary Hypertension 1
Pulmonary Hypertension 1
 
Pulmonary hypertension
Pulmonary  hypertensionPulmonary  hypertension
Pulmonary hypertension
 
Pul hypertension
Pul hypertensionPul hypertension
Pul hypertension
 
Pulmonary hypertension 27 06-19
Pulmonary  hypertension 27 06-19Pulmonary  hypertension 27 06-19
Pulmonary hypertension 27 06-19
 
8. Respiratory failure in human body.ppt
8. Respiratory failure in human body.ppt8. Respiratory failure in human body.ppt
8. Respiratory failure in human body.ppt
 
A Case of Idiopathic Pulmonary Hypertension
A Case of Idiopathic Pulmonary HypertensionA Case of Idiopathic Pulmonary Hypertension
A Case of Idiopathic Pulmonary Hypertension
 
Dyspnea
DyspneaDyspnea
Dyspnea
 

More from Nandish Sannaiah

Shock .pptx
Shock .pptxShock .pptx
Shock .pptx
Nandish Sannaiah
 
Pain.pptx
Pain.pptxPain.pptx
Pain.pptx
Nandish Sannaiah
 
Oral disorders .pptx
Oral disorders .pptxOral disorders .pptx
Oral disorders .pptx
Nandish Sannaiah
 
Liver Abcess.pptx
Liver Abcess.pptxLiver Abcess.pptx
Liver Abcess.pptx
Nandish Sannaiah
 
Gastro Intestinal bleeding.pptx
Gastro Intestinal bleeding.pptxGastro Intestinal bleeding.pptx
Gastro Intestinal bleeding.pptx
Nandish Sannaiah
 
Malabsorption.pptx
Malabsorption.pptxMalabsorption.pptx
Malabsorption.pptx
Nandish Sannaiah
 
Fissure.pptx
Fissure.pptxFissure.pptx
Fissure.pptx
Nandish Sannaiah
 
Excretory System.pptx
Excretory System.pptxExcretory System.pptx
Excretory System.pptx
Nandish Sannaiah
 
Peritonitis.pptx
Peritonitis.pptxPeritonitis.pptx
Peritonitis.pptx
Nandish Sannaiah
 
Colon Cancer.pptx
Colon Cancer.pptxColon Cancer.pptx
Colon Cancer.pptx
Nandish Sannaiah
 
GERD.pptx
GERD.pptxGERD.pptx
GERD.pptx
Nandish Sannaiah
 
Hemorrhoids.pptx
Hemorrhoids.pptxHemorrhoids.pptx
Hemorrhoids.pptx
Nandish Sannaiah
 
Ulcerative Colitis.pptx
Ulcerative Colitis.pptxUlcerative Colitis.pptx
Ulcerative Colitis.pptx
Nandish Sannaiah
 
Hiatal Hernia.pptx
Hiatal Hernia.pptxHiatal Hernia.pptx
Hiatal Hernia.pptx
Nandish Sannaiah
 
Cardiac Tamponade.pptx
Cardiac Tamponade.pptxCardiac Tamponade.pptx
Cardiac Tamponade.pptx
Nandish Sannaiah
 
Cholecystitis.pptx
Cholecystitis.pptxCholecystitis.pptx
Cholecystitis.pptx
Nandish Sannaiah
 
Gastritis.pptx
Gastritis.pptxGastritis.pptx
Gastritis.pptx
Nandish Sannaiah
 
Anemia.pptx
Anemia.pptxAnemia.pptx
Anemia.pptx
Nandish Sannaiah
 
Cardiogenic Shock.pptx
Cardiogenic Shock.pptxCardiogenic Shock.pptx
Cardiogenic Shock.pptx
Nandish Sannaiah
 
Polycythemia.pptx
Polycythemia.pptxPolycythemia.pptx
Polycythemia.pptx
Nandish Sannaiah
 

More from Nandish Sannaiah (20)

Shock .pptx
Shock .pptxShock .pptx
Shock .pptx
 
Pain.pptx
Pain.pptxPain.pptx
Pain.pptx
 
Oral disorders .pptx
Oral disorders .pptxOral disorders .pptx
Oral disorders .pptx
 
Liver Abcess.pptx
Liver Abcess.pptxLiver Abcess.pptx
Liver Abcess.pptx
 
Gastro Intestinal bleeding.pptx
Gastro Intestinal bleeding.pptxGastro Intestinal bleeding.pptx
Gastro Intestinal bleeding.pptx
 
Malabsorption.pptx
Malabsorption.pptxMalabsorption.pptx
Malabsorption.pptx
 
Fissure.pptx
Fissure.pptxFissure.pptx
Fissure.pptx
 
Excretory System.pptx
Excretory System.pptxExcretory System.pptx
Excretory System.pptx
 
Peritonitis.pptx
Peritonitis.pptxPeritonitis.pptx
Peritonitis.pptx
 
Colon Cancer.pptx
Colon Cancer.pptxColon Cancer.pptx
Colon Cancer.pptx
 
GERD.pptx
GERD.pptxGERD.pptx
GERD.pptx
 
Hemorrhoids.pptx
Hemorrhoids.pptxHemorrhoids.pptx
Hemorrhoids.pptx
 
Ulcerative Colitis.pptx
Ulcerative Colitis.pptxUlcerative Colitis.pptx
Ulcerative Colitis.pptx
 
Hiatal Hernia.pptx
Hiatal Hernia.pptxHiatal Hernia.pptx
Hiatal Hernia.pptx
 
Cardiac Tamponade.pptx
Cardiac Tamponade.pptxCardiac Tamponade.pptx
Cardiac Tamponade.pptx
 
Cholecystitis.pptx
Cholecystitis.pptxCholecystitis.pptx
Cholecystitis.pptx
 
Gastritis.pptx
Gastritis.pptxGastritis.pptx
Gastritis.pptx
 
Anemia.pptx
Anemia.pptxAnemia.pptx
Anemia.pptx
 
Cardiogenic Shock.pptx
Cardiogenic Shock.pptxCardiogenic Shock.pptx
Cardiogenic Shock.pptx
 
Polycythemia.pptx
Polycythemia.pptxPolycythemia.pptx
Polycythemia.pptx
 

Recently uploaded

Ocular injury ppt Upendra pal optometrist upums saifai etawah
Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
pal078100
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
د.محمود نجيب
 
Physiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdfPhysiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdf
MedicoseAcademics
 
Knee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdfKnee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdf
vimalpl1234
 
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists  Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Saeid Safari
 
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model SafeSurat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Savita Shen $i11
 
Ophthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE examOphthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE exam
KafrELShiekh University
 
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptxTriangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
The Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of IIThe Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of II
MedicoseAcademics
 
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
GL Anaacs
 
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptxHow STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
FFragrant
 
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdf
ARTIFICIAL INTELLIGENCE IN  HEALTHCARE.pdfARTIFICIAL INTELLIGENCE IN  HEALTHCARE.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdf
Anujkumaranit
 
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #GirlsFor Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
Savita Shen $i11
 
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Savita Shen $i11
 
NVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control programNVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control program
Sapna Thakur
 
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Oleg Kshivets
 
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTSARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
Dr. Vinay Pareek
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
greendigital
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Physiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of TastePhysiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of Taste
MedicoseAcademics
 

Recently uploaded (20)

Ocular injury ppt Upendra pal optometrist upums saifai etawah
Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
 
KDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologistsKDIGO 2024 guidelines for diabetologists
KDIGO 2024 guidelines for diabetologists
 
Physiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdfPhysiology of Chemical Sensation of smell.pdf
Physiology of Chemical Sensation of smell.pdf
 
Knee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdfKnee anatomy and clinical tests 2024.pdf
Knee anatomy and clinical tests 2024.pdf
 
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists  Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
 
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model SafeSurat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
Surat @ℂall @Girls ꧁❤8527049040❤꧂@ℂall @Girls Service Vip Top Model Safe
 
Ophthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE examOphthalmology Clinical Tests for OSCE exam
Ophthalmology Clinical Tests for OSCE exam
 
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptxTriangles of Neck and Clinical Correlation by Dr. RIG.pptx
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
 
The Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of IIThe Normal Electrocardiogram - Part I of II
The Normal Electrocardiogram - Part I of II
 
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...
 
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptxHow STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
 
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdf
ARTIFICIAL INTELLIGENCE IN  HEALTHCARE.pdfARTIFICIAL INTELLIGENCE IN  HEALTHCARE.pdf
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdf
 
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #GirlsFor Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
For Better Surat #ℂall #Girl Service ❤85270-49040❤ Surat #ℂall #Girls
 
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
 
NVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control programNVBDCP.pptx Nation vector borne disease control program
NVBDCP.pptx Nation vector borne disease control program
 
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
 
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTSARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
ARTHROLOGY PPT NCISM SYLLABUS AYURVEDA STUDENTS
 
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness JourneyTom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
 
Physiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of TastePhysiology of Special Chemical Sensation of Taste
Physiology of Special Chemical Sensation of Taste
 

Cor - Pulmonale.pptx

  • 1. COR - PULMONALE Presented By: Mr. Nandish.S Asso. Professor Mandya Institute of Nursing Sciences
  • 2.
  • 3. DEFINITION : Cor Pulmonale is a Latin word means “pulmonary heart”. It is defined as an alteration in the structure and function of right ventricle due to pulmonary hypertension. It is the enlargement of right ventricle secondary to diseases of lung, thorax or pulmonary circulation. It is the failure of right side of Heart caused by prolonged high blood pressure in the pulmonary artery & right ventricle. It is also called as right side heart failure.
  • 4. INCIDENCE & PREVALENCE :  It accounts for 6 – 7 % of all types of adult heart diseases.  50% of the cor pulmonale cases are due to Chronic Obstructive Pulmonary Disease.  Cor pulmonale varies among other countries depending on factors like cigarette smoking, air pollution and other lung disorders.
  • 5. ETIOLOGY : I. Diseases of the Lung parenchyma :  Chronic pulmonary obstructive disease - Emphysema - Chronic Bronchitis  Cystic Fibrosis  Idiopathic Interstitial Pneumonitis  Sarcoidosis  Bronchiectasis  Lymphangioleiomyomatosis
  • 6. II. Diseases of Pulmonary Vasculature  Pulmonary Arterial Hypertension (PAH) 1) Idiopathic 2) Heritable 3) Associated  Veno-occlusive disease  Chronic thromboembolic pulmonary hypertension  Pulmonary Tumor thrombotic microangiopathy
  • 7. III. Disorders of Chronic / Alveolar Hypoxia  Alveolar Hypoventilation syndromes  Obesity Hypoventilation syndrome  Central Hypoventilation syndrome  Neuromuscular Respiratory Failure  Chest wall disorders - Kyphoscoliosis  Living at High altitude
  • 8. PATHOPHYSIOLOGY : Genetic Factors Unknown Factors Pulmonary Endothelial Injury Vasoconstriction Remodelling (Vessel wall thickening) Sustained Pulmonary Hypertension Right Ventricular Hypertrophy Cor Pulmonale
  • 9. CLINICAL MANIFESTATIONS :  Dyspnoea  Chronic productive cough  Wheezing  Tachycardia  Retrosternal or Substernal pain  Fatigue  Chronic hypoxemia : it leads to polycythemia & total blood volume.
  • 10. ADDITIONAL MANIFESTATIONS :  Peripheral / Ankle edema  Weight gain  Distended neck veins / Jugular vein distension  Bounding pulse  Hepatomegaly  Cyanosis  Exertional Syncope  Lethargy  Chronic wet cough
  • 11. DIAGNOSTIC STUDIES :  History collection & Physical Examination  Chest X – Ray  Pulmonary Function Test  6 minute walk test  ECG (inverted T Wave)  Echocardiogram (right ventricular dilation)  ABG Analysis  Chest CT Angiography  Cardiac catheterization  Doppler studies (To monitor pulmonary artery pressure)  MRI (Cardiac Magnetic Resonance)
  • 12. MANAGEMENT : It is directed towards treating underlying pulmonary problem that precipitated heart disorder.  General Management  Specific Management  Management of complication  Management of acute exacerbation  Surgical management : Lung Transplantation
  • 13. GENERAL MANAGEMENT :  Education & Reassurance  Oxygen Therapy (long term low flow oxygen)  Low Level graded Aerobic exercises  Avoid heavy physical exertion  Sodium restricted diet ( < 2400 mg / day)  Routine immunization  Cessation of smoking
  • 14. SPECIFIC MANAGEMENT :  Endothelin receptor antagonist Ambrisentan, Bosentan, Macitentan  Prostacyclin (PGI2) Analogues Epoprostenol – intravenous formulation Treprostinil – subcutaneous Iloprost – inhalation  Phosphodiesterase Type 5 (PDE5) inhibitors Sildenafil, Tadalafil , Vardenafil  Calcium Channel blockers Diltiazem
  • 15. MANAGEMENT OF COMPLICATION : Warfarin  Anticoagulation with warfarin is recommended in patients at high risk for thromboembolism.  Recommended dosage is 1.5 to 2.5 as prophylaxis. Diuretics  Are used to decrease the elevated right ventricular filling volume in patients with chronic cor pulmonale.  A combination of Loop diuretic (Furosemide) and Potassium sparing diuretic (Spironolactone) is used for better response.
  • 16. MANAGEMENT OFACUTE EXACERBATION:  Hospitalization  Oxygen therapy  Control of heart failure  Control of cardiac arrhythmia  Control of infection  Treatment of lung disease accordingly.
  • 17. NURSING DIAGNOSIS :  Decreased cardiac output related to restricted cardiac muscle contractility as evidenced by Doppler study finding.  Impaired gas exchange related to expiratory airflow obstruction as manifested by reduced oxygen saturation level.  Impaired tissue perfusion related to decreased cardiac contractility as manifested by capillary refill time more than 3 seconds.  Activity intolerance related to laboured respirations as manifested by difficulty in performing ADL.  Anxiety related to disease progression as evidenced by patient’s verbalization & facial expression.