Medical history (history of illness) represents an important component in the diagnosis of cor pulmonale. Family history Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social history What is your profession? Are you exposed to harmful working substances in your profession? Current medical history/systemic medical … Cor Pulmonale: Medical History
Respiratory System (J00-J99) Bronchial asthma Bronchiectasis (synonym: bronchiectasis) – persistent irreversible saccular or cylindrical dilatation of the bronchi (medium-sized airways) that may be congenital or acquired; symptoms: chronic cough with “mouthful expectoration” (large-volume triple-layered sputum: foam, mucus, and pus), fatigue, weight loss, and decreased exercise capacity Chronic bronchitis Chronic obstructive pulmonary disease (COPD) Idiopathic pulmonary … Cor Pulmonale: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by cor pulmonale: Cardiovascular system (I00-I99). Cardiovascular failure Right heart failure (reduced performance of the right heart). Atrial fibrillation (VHF) Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99). Dyspnea (shortness of breath) Edema (water retention) Further Limited life … Cor Pulmonale: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing) due topossible: Neck vein congestion? Signs of increased right ventricular filling pressure include jugular venous congestion (JVD) or increased jugular venous pressure (JVP). Elevated JVD is commonly seen in … Cor Pulmonale: Examination
Laboratory parameters of 1st order – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein). Fasting glucose (fasting blood sugar) Blood gas analysis (BGA) Highly sensitive cardiac troponin T (hs-cTnT) or troponin I (hs-cTnI); creatine kinase (CK, CK-MB), lactate dehydrogenase (LDH) – if myocardial infarction (heart attack) is suspected. D-dimer – for … Cor Pulmonale: Lab Test
Therapeutic target Improvement of prognosis. Curative therapy does not exist. Therapy recommendations Treatment of the underlying disease Reduction of pressure in the pulmonary circulation: Initial therapy depending on the degree of heart failure/heart failure (NYHA): endothelin receptor antagonists (see below), PDE-5 inhibitors (see below), prostacyclin analogs (see below); note: Therapy should be performed at specialized … Cor Pulmonale: Drug Therapy
Mandatory medical device diagnostics. Electrocardiogram (ECG; recording of the electrical activity of the heart muscle) – Change in ECG usually occurs late or is absent in a large proportion of patients. The following change may occur in cor pulmonale: Right heart hypertrophy sign (sign of right heart enlargement): Elevation of the R-wave in leads V1 … Cor Pulmonale: Diagnostic Tests
To prevent cor pulmonale, attention must be paid to reducing individual risk factors. Cor pulmonale chronicum Behavioral risk factors Overweight (BMI ≥ 25, obesity). Living at high altitude
The following symptoms and complaints may indicate cor pulmonale: Mild cases of chronic cor pulmonale may lack symptoms at rest. Leading symptoms of cor pulmonale acutum. Sudden onset of dyspnea (shortness of breath). Cardiac arrhythmia Vertigo (dizziness) Signs of right heart failure: Neck vein congestion Congestive liver Edema, peripheral (water retention) Tachycardia – too fast … Cor Pulmonale: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Cor pulmonale acutum develops acutely from pulmonary embolism or from an attack in the setting of bronchial asthma. Cor pulmonale chronicum develops from pulmonary hypertension (pulmonary hypertension), which is caused by changes in the pulmonary vessels or lung tissue. Etiology (causes) of cor pulmonale acutum Disease-related causes Respiratory System (J00-J99) Status … Cor Pulmonale: Causes
General measures Pregnancy should be avoided. Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program. BMI ≥ 25 → participation in a medically supervised weight loss program. Travel recommendations: No travel … Cor Pulmonale: Therapy
