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Pulmonary Heart Disease
Pulmonary heart disease medically known as Cor Pulmonale is a change in the structure and function of the right ventricle, one of the four chambers in the human heart that receives de-oxygenated blood from the right atrium and pumps it into the pulmonary artery, this failure of the right side of the heart results to a respiratory disorder. Pulmonary heart disease is caused by prolonged high blood pressure in the pulmonary artery and the right ventricle of the heart.
Normally, the left side of the heart pumps blood to the body so it produces a higher level of blood pressure. The right side of the heart on the other hand, pumps blood through the lungs under a much lower pressure, any condition that leads to prolonged high blood pressure in the arteries or veins of the lungs called pulmonary hypertension, will not be tolerated by the right ventricle of the heart causing it to fail or unable to pump blood against abnormal high pressures, this is called Cor Pulmonale or Pulmonary Heart Disease.
Chronic lung disease or condition which causes prolonged low blood oxygen can lead to pulmonary heart disease. These causes includes chronic obstructive pulmonary disease (COPD), obstructive sleep apnea, mountain sickness, cystic fibrosis, central sleep apnea, pneumoconiosis, primary pulmonary hypertension, kyphoscoliosis, diffuse interstitial pulmonary fibrosis, pulmonary hypertension, pulmonary vascular disease, and chronic thromboembolic pulmonary disease.
Symptoms of pulmonary heart disease includes shortness of breath, swelling of the feet or ankles, chest discomfort, exercise intolerance, and symptoms of underlying disorders such as wheezing and coughing. Some signs to pulmonary heart disease are having a bluish color to the skin (cyanosis), abnormal fluid collection in the abdomen and enlargement of the liver, distension of the neck veins indicating high right-heart pressures, abnormal heart sounds, and swelling of the ankles.
To diagnose pulmonary heart disease or cor pulmonale, the following tests may help:
* CAT scan of the chest
* Swan-Ganz catheterization
* V/Q scan
* Chest X-ray
* Echocardigram or heart ultrasound
* Lung biopsy, which is not often performed
* Measurement of blood oxygen by arterial blood gas (ABG)
* Blood test for brain natriuretic peptide (BNP)
* Blood antibody tests
The most important intervention for cor pulmonale is elimination of the cause. Treatment is aimed at the underlying illness and supplemental oxygen may be prescribed to increase the oxygen level in the blood. Low salt diet is also often recommended together with diuretic medicines which may be given to remove excess fluid from the body. To treat pulmonary hypertension, intravenous prostacyclin, calcium channel blockers, or oral medication bosentan may be used. Sometimes surgery is used to reverse heart effects that cause cor pulmonale. Anticoagulant or blood thinning medications may also be prescribed.
A healthy life style and avoiding behaviors that can lead to chronic lung disease especially cigarette smoking may prevent the development of cor pulmonale.
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