Medical

1. Cor Pulmonale
• Definition:
• Cor pulmonale is right ventricular hypertrophy
and failure due to pulmonary hypertension
caused by chronic lung diseases.

2. Etiology
• • Chronic obstructive pulmonary disease
(COPD)
• • Pulmonary hypertension
• • Interstitial lung diseases
• • Obstructive sleep apnea
• • Chronic pulmonary embolism

3. Pathophysiology
• • Chronic lung disease leads to hypoxia and
vasoconstriction.
• • Increased pulmonary vascular resistance
causes right ventricular hypertrophy.
• • Eventually, right heart failure occurs.

4. Signs and Symptoms
• • Dyspnea on exertion
• • Fatigue
• • Peripheral edema
• • Jugular venous distension (JVD)
• • Ascites
• • Hepatomegaly

5. Medical Management
• • Oxygen therapy (2-4 L/min via nasal
cannula)
• • Diuretics (Furosemide 20-80 mg IV/PO)
• • Vasodilators (Sildenafil 20 mg PO TID)
• • Inotropic agents (Digoxin 0.125-0.25 mg PO
daily)

6. Nursing Interventions
• • Monitor oxygen saturation and administer
oxygen as prescribed.
• • Assess for fluid overload and monitor daily
weight.
• • Educate patient on low-sodium diet and fluid
restriction.
• • Encourage smoking cessation.

7. Surgical Intervention
• • Lung transplant in severe cases
• • Pulmonary thromboendarterectomy (for
chronic thromboembolic disease)

8. Complications
• • Right heart failure
• • Arrhythmias
• • Severe hypoxemia

9. Prevention
• • Manage underlying lung disease
• • Avoid smoking
• • Regular pulmonary rehabilitation

10. Pulmonary Embolism
• Definition:
• Pulmonary embolism (PE) is a blockage of the
pulmonary artery by a thrombus, air, fat, or
amniotic fluid.

11. Etiology
• • Deep vein thrombosis (DVT)
• • Hypercoagulable states (e.g., cancer,
pregnancy)
• • Prolonged immobility
• • Post-surgical complications
• • Trauma

12. Pathophysiology
• • A thrombus dislodges and travels to the
pulmonary arteries.
• • It obstructs blood flow, leading to
ventilation-perfusion mismatch.
• • Hypoxia and increased pulmonary vascular
resistance occur, possibly leading to shock.

13. Signs and Symptoms
• • Sudden dyspnea
• • Chest pain (pleuritic)
• • Hemoptysis
• • Tachypnea
• • Tachycardia
• • Hypotension (in massive PE)

14. Medical Management
• • Anticoagulants (Heparin IV 5000 units bolus,
then 1000 units/hr)
• • Thrombolytics (Alteplase 100 mg IV over 2
hours)
• • Oxygen therapy (as needed to maintain
SpO2 >90%)
• • Pain management (Morphine 2-4 mg IV PRN)

15. Surgical Intervention
• • Pulmonary embolectomy in life-threatening
cases
• • Inferior vena cava (IVC) filter placement

16. Pulmonary Edema
• Definition:
• Pulmonary edema is the accumulation of fluid
in the alveoli and interstitial spaces of the
lungs, leading to impaired gas exchange.

17. Etiology
• • Left heart failure
• • Acute myocardial infarction
• • Hypertension crisis
• • Kidney failure
• • High-altitude exposure

18. Pathophysiology
• • Increased hydrostatic pressure in pulmonary
capillaries causes fluid to leak into alveoli.
• • Gas exchange is impaired, leading to
hypoxia.
• • Surfactant dilution further worsens lung
compliance.

19. Signs and Symptoms
• • Severe dyspnea
• • Pink, frothy sputum
• • Crackles on auscultation
• • Hypoxemia
• • Orthopnea

20. Medical Management
• • Oxygen therapy (High-flow or CPAP if severe)
• • Diuretics (Furosemide 40 mg IV)
• • Vasodilators (Nitroglycerin 5 mcg/min IV,
titrate as needed)
• • Morphine (2-4 mg IV for anxiety and
vasodilation)

21. Prevention
• • Control blood pressure and heart disease
• • Monitor fluid balance in at-risk patients
• • Avoid excessive IV fluids in heart failure
patients