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{{DiseaseDisorder infobox | Name = Cor pulmonale |
ICD10 = {{ICD10|I|26||i|26-->, {{ICD10|I|27||i|26--> |
ICD9 = {{ICD9|415.0--> |
-->
Cor pulmonale, also known as right heart failure, is a medical term used to describe a change in structure and function of the right ventricle of the heart as a result of a Respiratory system disorder.
Right ventricular hypertrophy or RVH is the predominant change in
chronic (medicine) cor pulmonale although in Acute (medical) cases
dilation dominates. Both hypertrophy and dilation are the result of increased right ventricular pressure.
Dilation is essentially a stretching of the ventricle, the immediate result of increasing the pressure in an elastic container. Ventricular hypertrophy is an adaptive response to a long-term increase in pressure. Additional muscle grows to allow for the increased contractile force required to move the blood against greater resistance.
To be classified as cor pulmonale, the cause must originate in the
pulmonary circulation system. Two major causes are vascular changes as a result of tissue damage (e.g. disease,
hypoxia (medical), chemical agents etc.), and chronic
hypoxic pulmonary vasoconstriction. RVH due to a
systemic defect is not classified as cor pulmonale.
Left untreated, cor pulmonale can lead to right-heart failure and death.
Pathophysiology
There are several mechanisms leading to pulmonary hypertension and cor pulmonale:
- Pulmonary vasoconstriction
- Anatomic changes in vascularization
- Increased blood viscosity
- pulmonary hypertension
Causes
- Acute:
- Pulmonary embolism
- Exacerbation of chronic cor pulmonale
- Chronic:
- Chronic obstructive pulmonary disease
- Loss of lung tissue following trauma or surgery
- Pierre Robin Sequence
- End stage Pneumoconiosis
Complications
Blood backs up into the systemic venous system, including the
hepatic vein. Chronic congestion in the Hepatic lobule region of the liver leads to hypoxia and fatty changes of more peripheral hepatocytes, leading to what is known as
nutmeg liver.
Treatment
Elimination of the cause is the most important intervention. In
pulmonary embolism,
thrombolysis (enzymatic dissolution of the blood clot) is advocated if there is dysfunction of the right ventricle. In COPD, long-term oxygen therapy may improve cor pulmonale.
Cor pulmonale may lead to
congestive heart failure (CHF), with worsening of respiration due to pulmonary edema, swelling of the legs due to peripheral edema and painful congestive hepatomegaly (enlargement of the liver due to tissue damage as explained in the
Cor pulmonale#Complications section. This situation requires diuretics (to decrease strain on the heart), sometimes
nitrates (to improve blood flow),
phosphodiesterase inhibitors such as sildenafil or tadalafil, and occasionally inotropes (to improve heart contractility). CHF is a negative prognosis in cor pulmonale.
External links
- Emedicine
- The Merck Manual of Diagnosis and Therapy: Cor Pulmonale
- Pulmonary Heart Disease Symptoms
{{DiseaseDisorder infobox | Name = Cor pulmonale |
ICD10 = {{ICD10|I|26||i|26-->, {{ICD10|I|27||i|26--> |
ICD9 = {{ICD9|415.0--> |
-->
Cor pulmonale, also known as right heart failure, is a medical term used to describe a change in structure and function of the
right ventricle of the heart as a result of a
Respiratory system disorder.
Right ventricular hypertrophy or RVH is the predominant change in chronic (medicine) cor pulmonale although in
Acute (medical) cases
dilation dominates. Both hypertrophy and dilation are the result of increased right ventricular pressure.
Dilation is essentially a stretching of the ventricle, the immediate result of increasing the pressure in an elastic container. Ventricular hypertrophy is an adaptive response to a long-term increase in pressure. Additional muscle grows to allow for the increased contractile force required to move the blood against greater resistance.
To be classified as cor pulmonale, the cause must originate in the
pulmonary circulation system. Two major causes are vascular changes as a result of tissue damage (e.g. disease,
hypoxia (medical), chemical agents etc.), and chronic hypoxic pulmonary vasoconstriction. RVH due to a systemic defect is not classified as cor pulmonale.
Left untreated, cor pulmonale can lead to right-heart failure and death.
Pathophysiology
There are several mechanisms leading to pulmonary hypertension and cor pulmonale:
Causes
Complications
Blood backs up into the systemic venous system, including the
hepatic vein. Chronic congestion in the
Hepatic lobule region of the liver leads to hypoxia and fatty changes of more peripheral hepatocytes, leading to what is known as nutmeg liver.
Treatment
Elimination of the cause is the most important intervention. In pulmonary embolism,
thrombolysis (enzymatic dissolution of the blood clot) is advocated if there is dysfunction of the right ventricle. In COPD, long-term oxygen therapy may improve cor pulmonale.
Cor pulmonale may lead to congestive heart failure (CHF), with worsening of respiration due to
pulmonary edema, swelling of the legs due to
peripheral edema and painful congestive hepatomegaly (enlargement of the liver due to tissue damage as explained in the Cor pulmonale#Complications section. This situation requires diuretics (to decrease strain on the heart), sometimes
nitrates (to improve blood flow), phosphodiesterase inhibitors such as sildenafil or
tadalafil, and occasionally
inotropes (to improve heart contractility). CHF is a negative
prognosis in cor pulmonale.
External links
- Emedicine
- The Merck Manual of Diagnosis and Therapy: Cor Pulmonale
- Pulmonary Heart Disease Symptoms
Cor Pulmonale
Cor Pulmonale - Synonyms: Right-sided heart failure/right ventricular failure secondary to pulmonary disease.
Cor pulmonale - Wikipedia, the free encyclopedia
Cor pulmonale is a change in structure and function of the right ventricle of the heart as a result of a respiratory disorder. Right ventricular hypertrophy or RVH is the ...
MedlinePlus Medical Encyclopedia: Cor pulmonale
A definition, causes, and risk factors for cor pulmonale.
cor pulmonale - General Practice Notebook
Cor pulmonale is lung disease complicated by the following: right ventricular failure; fluid retention; chronic hypoxia; Excluded is right ventricular enlargement secondary to:
Definition: cor pulmonale from Online Medical Dictionary
The Online Medical Dictionary is a searchable dictionary of definitions from medicine, science and technology.
Cor Pulmonale-Diseases
What is this condition?A chronic heart condition, cor pulmonale is an enlargement of the right ventricle that results from various lung diseases, except those that primarily affect ...
eMedicine - Cor Pulmonale : Article by Ali A Sovari, MD
Overview of the disease along with clinical information, treatments, and medications.
Results For "cor pulmonale" - SearchMedica - Professional Medical ...
1 eMedicine - Cor Pulmonale : Article by Ali A Sovari, MD... pulmonale but cor pulmonale can develop secondary to a wide variety of ...
Cor pulmonale
Cor pulmonale. Cor pulmonale - Medicine Guide. Cor pulmonale: This is a heart condition caused by a disease of the lungs.
Cor pulmonale Information on Healthline
Cor pulmonale is failure of the right side of the heart caused by prolonged high blood pressure in the pulmonary artery and right ventricle of the heart.
