Cor pulmonale corresponds to an alteration of the right ventricle due to lung disease. The right ventricle is a structure belonging to the cardiovascular system responsible for transporting blood from the heart to the lungs and which, due to pulmonary diseases, mainly to Chronic Obstructive Pulmonary Disease (COPD), can undergo structural and, consequently, functional changes. Learn how to identify and treat COPD.
Cor pulmonale can be classified as acute or chronic:
- Acute cor pulmonale: can be caused due to pulmonary embolism or injury resulting from mechanical ventilation and is usually easily reversible; Chronic cor pulmonale: it is mainly caused by COPD, but it can also be due to the loss of lung tissue due to surgery, pulmonary fibrosis, disorders involving the respiratory muscles or due to chronic pulmonary embolism.
The diagnosis is made based on the symptoms and laboratory and imaging exams, such as echocardiography, in which the cardiac structures are observed in real time, in which case a structural alteration of the right ventricle is visualized.
Main causes
In the presence of lung diseases, the blood passes through the pulmonary veins and arteries with difficulty, characterizing pulmonary hypertension, which causes the cardiac structures, especially the right ventricle, to be overloaded.
Pulmonary hypertension and, consequently, cor pulmonale can be caused by:
- Chronic Obstructive Pulmonary Disease; Pulmonary embolism; Cystic Fibrosis; Scleroderma; Pulmonary emphysema; Heart failure
In addition, changes in vascularity and increased blood viscosity can result in pulmonary hypertension. Learn more about pulmonary hypertension.
Symptoms of cor pulmonale
Initially, cor pulmonale is asymptomatic, however non-specific symptoms may appear, such as:
- Extreme tiredness; Cyanosis; Cough with phlegm or blood; Difficulty or wheezing when breathing; Chest pain; Swelling of the lower limbs; Enlarged liver; Dilatation of the jugular veins, which are the veins located in the neck; Yellow eyes.
The diagnosis is made through the assessment of symptoms and tests such as laboratory tests, such as blood gas analysis and blood count, for example, electrocardiogram and echocardiogram, which is done to assess the structures of the heart in real time, and can be perceived through this examining the change in the right ventricle. Understand how the echocardiogram is done.
In addition, other tests may be ordered to confirm the diagnosis, such as chest tomography, lung biopsy and pulmonary vein angiotomography. See what angiotomography is for.
How the treatment is done
The treatment of cor pulmonale is done according to the associated lung disease, and improvement of oxygenation, decreased fluid retention, control of pulmonary disease and improvement of right ventricular function is usually recommended.
It may be recommended by the media to use drugs that improve circulation and decrease pressure within the lung, such as antihypertensives and anticoagulants, for example. In more severe cases, however, a heart or lung transplant may be necessary to resolve the cor pulmonale.
