Cor Pulmonale right sided Heart Failure caused by chronic pulmonary artery Essential hypertension.
Causes/Factors
- COPD
- Pulmonary vascular disorders
- interstitial lung disease
- Thoracic cage abnormalities
- Sleep apnoea
Symptoms
Lack of perfusion
- Dyspnoea
- Fatigue
- Syncope
Signs
- Cyanosis
- Tachycardia
- Raised JVP with prominent a and v waves
- RV heave
- Loud pan-systolic murmur Tricuspid regurgitation
- Early diastolic Graham Steell murmur
- Hepatomegaly and oedema
Diagnostic Tests
- FBC - Hb and haematocrit (secondary polycythaemia)
- ABG - hypoxic hypercapnia
- CXR - enlarged right A & V, prominent pulmonary arteries
- ECG - right axis deviation + right ventricular hypertrophy
Management
- Treat underlying cause
- Treat Respiratory Failure
- Treat Heart Failure
- Consider venesection
- Consider heart-lung transplant in young patients
Complications/red Flags
Poor prognosis - 50% 5 year mortality