Patient will present as → a 65-year-old man who presents with a chronic productive cough, dyspnea, and wheezing. Examination reveals cyanosis, distended neck veins, and a prominent epigastric pulsation
Cor pulmonale is right ventricular enlargement and eventually failure secondary to a lung disorder that causes pulmonary artery hypertension.
- Lung disorders such as PE, vasculitis, ARDS, COPD (most common), Asthma, and ILD causes pulmonary artery hypertension.
- Pulmonary artery hypertension then leads to right ventricular failure
- Findings include peripheral edema, neck vein distention, hepatomegaly, and a parasternal lift
Diagnosis usually requires echocardiography or radionuclide imaging and sometimes right heart catheterization
Diagnose and treat the underlying disorder
- Early identification and treatment of the cause are important before cardiac structural changes become irreversible
- Although patients may have significant peripheral edema, diuretics are not helpful and may be harmful; small decreases in preload often worsen cor pulmonale
acute coronary syndrome
Marked hypotension in acute coronary syndrome occurs when the right coronary artery is affected. Acute coronary syndromes do not usually present with systolic murmurs, but patients will complain of angina and the ECG changes will include ST-segment changes.
Patients who have severe heart failure will have similar symptoms but also have pulsus alternans and pulmonary rales.
patients with pulmonary embolus may have hemodynamic changes but usually have a low PaO2 and a normal PaCO2. ECG may show right-axis deviation in a pulmonary embolus as well.