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Cor Pulmonale (Right HF) (Clinical Signs and Symptoms (Cyanosis (Fingers…
Cor Pulmonale (Right HF)
Etiology
LV failure
RV infarction
Pulmonary hypertension :star:
Tricuspid regurgitation
Pathophysiology
Increased viscosity of the blood (Polycythemia)
Increased Pulmonary Vascular Resistance (PVR) caused by hypoxic vasoconstriction
Obliteration of the pulmonary capillary bed
Diagnostic Tests
Lab findings
ELEVATED BNP
Echocardiography
Show size and thickness of RV and R atrium
CXR
Enlargement of pulmonary arteries :red_flag:
Enlargement of right ventricle and atrium :red_flag:
Pleural effusion
Right heart catherization (Swan-Ganz catheter)
Hemodynamic status
High Pulmonary artery pressure :red_flag:
CT scan
Rule out underlying etiologies or conditions
MRI
Differential Diagnosis
Distended neck veins :red_flag:
Swans-Ganz catheter
High pulmonary artery pressure :red_flag:
CXR
Enlargement of pulmonary arteries :red_flag:
Enlargement of right ventricle and atrium :red_flag:
Respiratory Management
Oxygen therapy
Decrease WOB
Treat hypoxemia
Decrease myocardial work
Aerosolized medication
Bronchodilator
iNO
Treats pulmonary hypertension
Clinical Signs and Symptoms
Jugular vein distention :red_flag:
Peripheral edema
Hepatomegaly
Ascites: fluid in abdomen
SOB with exertion
Light headedness
Increased HR
Chest pain
Cyanosis
Fingers and Lips
Cough and hemoptysis
BS: Wheezing
Irregular fast HR
Heart palpitations
Frequent urination at night
Anorexia
Nausea
Indicates
Increased right ventricular work
Pulmonary arterial hypertension
Right ventricular hypertrophy
Right ventricular failure