Cor pulmonale

Cor pulmonale is a medical condition referring to the structural and functional changes of the right side of the heart as a result of a long-standing high blood pressure. If not treated properly, cor pulmonale may lead to complications such as shock, severe fluid retention and shortness of breath, all of which could be fatal. ^{[1] [2]}

Causes

Under normal condition, the left side of the heart generates a higher blood pressure than the right side. When there is a high blood pressure in the arteries located in the lungs, it is referred to as pulmonary hypertension. When pulmonary hypertension occurs, the right side of the heart experiences difficulty pumping blood and when this is present for a relatively long time, the result is cor pulmonale. 

Long term lung diseases usually lead to cor purmonale. These diseases include chronic obstructive pulmonary disease (COPD), interstitial lung disease and long term blood clots in the lungs. ^[1] In developed countries, the most common cause is COPD with the majority of cases attributed to tobacco smoking. ^[3]

Signs and Symptoms

Symptoms are often subtle during the early course of the disease. At the outset, a person often experiences shortness of breath or light headedness. Most symptoms are nonspecific including fatigue, increased rate of breathing and cough. Over time, the symptoms may worsen. The patient may have increased heart rate even at rest, swelling of the ankles, coughing out of bright red blood, hoarseness, labored breathing, bluish discoloration of the lips and skin and fainting spells. ^{[1] [2] [3]}

Diagnosis

After getting the patient’s medical history, a physical examination is often performed. In a patient with cor pulmonale, the physical exam may reveal abnormal heart sounds, fluid buildup in the abdomen and distention of veins in the neck. Laboratory tests that may help in making the diagnosis include chest x-ray, echocardiogram, pulmonary function tests and measurement of blood oxygen by arterial blood gas. ^[1]

Treatment

The objective is to control the symptoms. Among the drugs that can be prescribed are vasodilators like nifedipine, diuretics like furosemide and anticoagulants. Some patients may need long term oxygen therapy. Smoking cessation, avoidance of strenuous activities and staying away from high altitude places may help. ^{[1] [3]}

References:

1.      http://www.nlm.nih.gov/medlineplus/ency/article/000129.htm

2.      http://emedicine.medscape.com/article/154062-overview

3.      http://www.patient.co.uk/doctor/cor-pulmonale