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Corpulmonale
- 1. COR PULMONALE PRESENTED BY Mrs.SOUMYA SUBRAMANI, M.Sc.(N) LECTURER, MSN DEPARTMENT CON- SRIPMS, COIMBATORE.
- 2. Definitions It is thehypertrophy of the right ventricle resulting from diseases affecting the function and/or structure of the lungs, except when these pulmonary alterations are the result of diseases that primarily affect the left side of the heart or congenital heart diseases” - The world Health Organizaton in 1963
- 3. Cor pulmonale isa disease of the right ventricle characterized hypertrophy and dilation that results from diseases directly affecting the lung parenchyma or lung vasculature.
- 4. DEFINITION It is theenlargement of the right ventricle secondary to diseases of the lung , thorax, or pulmonary circulation. (Lewis)
- 5. Etiology Diseases of lung parenchyma Diseasesof pulmonary vasculature Disorders of alveolar hypoxia
- 6. Diseases of lungparenchyma • COPD • Cystic fibrosis • Idiopathic interstitial pneumonitis Idiopathic pulmonary fibrosis Non specific interstitial pneumonitis • Sarcoidosis • Bronchiectasis • Bronchiololitis obliterans • Pulmonary Langerhans cell histiocytosis
- 7. Disorders of chronichypoxia • Alveolar hypoventilation syndrome • Obesity hypoventilation syndrome • Neuromuscular respiratory failure • Chest wall disorders -Kyphosis • Living at high altitude • Hypoventilation syndrome including OSA, central sleep apnea, obesity hypoventilation syndrome
- 8. Diseases of pulmonaryvasculature – Pulmonary arterial hypertension – Idiopathic PAH – Venoocclusive diseases – Chronic thromboembolic pulmonary hypertension – Pulmonary tumor thrombolic microangiopathy
- 9. Pathophysiology Lung diseases andother causes Inflammation, fibrosis, Hypoxia Increased arterial stiffness, endothelial dysfunction, vascular remodelling Persistant PAH RV hypertrophy, RV Failure Corpulmonale
- 10. Clinical types • Acutecorpulmonale • Chronic corpulmonale
- 11. CLINICAL MANIFESTATIONS • Dyspnea •Chronic productive cough • Wheezing respirations • Retrosternal or substernal pain • Fatigue • Polycythemia
- 12. CLINICAL MANIFESTATIONS If heartfailure accompanies cor pulmonale additional manifestations such as • Peripheral edema • Weight gain • Distended neck veins • Full bounding pulse • Enlarged liver
- 13. CLINICAL MANIFESTATIONS • Palpitation •Atypical chest pain • Swelling of the lower extremities • Dizziness and even syncope
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- 18. Chest X-RAY: Enlarged pulmonaryartery. Enlarged right ventricle. Distended azygous or Westermark sign “oligemia of lung lobe or entire lung Hampton’s hump “wedge shaped opacity” COPD signs as anterior-posterior diameter flattening of diaphragm honeycoomb
- 19. DIAGNOSIS • MAGNETIC RESONANCE IMAGING •NUCLEAR IMAGING
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- 22. MEDICAL MANAGEMENT • OXYGENTHERAPY
- 23. MEDICAL MANAGEMENT • PHARMACOTHERAPY •Diueretics • Anticoagualnts • Vasodialators • Anticoagulants • Calcium chanel blocker • Endothelin receptor antagonist • Bronchodialators • Antibiotics, expectorants
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- 25. SURGICAL MANAGEMENT • LUNGTRANSPLANTATION