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Information about Cor Pulmonale

Cor pulmonale
Classification & external resources
ICD-10I26., I27.
ICD-9415.0


Cor pulmonale, also known as right heart failure, is a medical term used to describe a change in structure and function of the right ventricle of the heart as a result of a respiratory disorder. Right ventricular hypertrophy or RVH is the predominant change in chronic cor pulmonale although in acute cases dilation dominates. Both hypertrophy and dilation are the result of increased right ventricular pressure.

Dilation is essentially a stretching of the ventricle, the immediate result of increasing the pressure in an elastic container. Ventricular hypertrophy is an adaptive response to a long-term increase in pressure. Additional muscle grows to allow for the increased contractile force required to move the blood against greater resistance.

To be classified as cor pulmonale, the cause must originate in the pulmonary circulation system. Two major causes are vascular changes as a result of tissue damage (e.g. disease, hypoxic injury, chemical agents etc.), and chronic hypoxic pulmonary vasoconstriction. RVH due to a systemic defect is not classified as cor pulmonale.

Left untreated, cor pulmonale can lead to right-heart failure and death.

Pathophysiology

There are several mechanisms leading to pulmonary hypertension and cor pulmonale:

Causes

Complications

Blood backs up into the systemic venous system, including the hepatic vein. Chronic congestion in the centrilobular region of the liver leads to hypoxia and fatty changes of more peripheral hepatocytes, leading to what is known as nutmeg liver.

Treatment

Elimination of the cause is the most important intervention. In pulmonary embolism, thrombolysis (enzymatic dissolution of the blood clot) is advocated if there is dysfunction of the right ventricle. In COPD, long-term oxygen therapy may improve cor pulmonale.

Cor pulmonale may lead to congestive heart failure (CHF), with worsening of respiration due to pulmonary edema, swelling of the legs due to peripheral edema and painful congestive hepatomegaly (enlargement of the liver due to tissue damage as explained in the Complications section. This situation requires diuretics (to decrease strain on the heart), sometimes nitrates (to improve blood flow), phosphodiesterase inhibitors such as sildenafil or tadalafil, and occasionally inotropes (to improve heart contractility). CHF is a negative prognostic indicator in cor pulmonale.

External links

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Circulatory system pathology (, )
HypertensionHypertensive heart disease - Hypertensive nephropathy - Secondary hypertension (Renovascular hypertension)
Ischaemic heart diseaseAngina pectoris - Prinzmetal's angina - Myocardial infarction - Dressler's syndrome
Pulmonary circulationPulmonary embolism - Cor pulmonale
PericardiumPericarditis - Pericardial effusion - Cardiac tamponade
Endocardium/heart valvesEndocarditis - Mitral regurgitation - Mitral valve prolapse - Mitral stenosis - Aortic valve stenosis - Aortic insufficiency - Pulmonary valve stenosis
MyocardiumMyocarditis - Cardiomyopathy (Dilated cardiomyopathy, Hypertrophic cardiomyopathy, Loeffler endocarditis, Restrictive cardiomyopathy) - Arrhythmogenic right ventricular dysplasia
Electrical conduction system
of the heart		Heart block: AV block (First degree, Second degree, Third degree) - Bundle branch block (Left, Right) - Bifascicular block - Trifascicular block
Pre-excitation syndrome (Wolff-Parkinson-White, Lown-Ganong-Levine) - Long QT syndrome - Adams-Stokes syndrome - Cardiac arrest
Arrhythmia: Paroxysmal tachycardia (Supraventricular, AV nodal reentrant, Ventricular) - Atrial flutter - Atrial fibrillation - Ventricular fibrillation - Premature contraction (Atrial, Ventricular) - Sick sinus syndrome
Other heart conditionsHeart failure - Cardiomegaly - Ventricular hypertrophy (Left, Right)
Cerebrovascular diseasesIntracranial hemorrhage/cerebral hemorrhage: Extra-axial hemorrhage (Epidural hemorrhage, Subdural hemorrhage, Subarachnoid hemorrhage) - Intra-axial hematoma (Intraventricular hemorrhages, Intraparenchymal hemorrhage) - Anterior spinal artery syndrome - Binswanger's disease - Moyamoya disease
Arteries, arterioles
and capillaries		Atherosclerosis (Renal artery stenosis) - Aortic dissection/Aortic aneurysm (Abdominal aortic aneurysm) - Aneurysm - Raynaud's phenomenon/Raynaud's disease - Buerger's disease - Arteritis (Aortitis) - Intermittent claudication - Arteriovenous fistula - Hereditary hemorrhagic telangiectasia - Spider angioma
Veins, lymphatic vessels
and lymph nodes		Thrombosis/Phlebitis/Thrombophlebitis (Deep vein thrombosis, May-Thurner syndrome, Portal vein thrombosis, Venous thrombosis, Budd-Chiari syndrome, Renal vein thrombosis, Paget-Schroetter disease) - Varicose veins (Hemorrhoid, Esophageal varices, Varicocele, Gastric varices, Caput medusae) - Superior vena cava syndrome - Lymph(Lymphadenitis, Lymphedema, Lymphangitis)
See also (, )
For other uses of "ICD", see ICD (disambiguation).


The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
..... Click the link for more information.
List of ICD-10 codes. The version for 2007 is available online at [1]

Chapter Blocks Title
I Certain infectious and parasitic diseases
II Neoplasms
III Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
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For other uses of "ICD", see ICD (disambiguation).


The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD
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The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. These codes are in the public domain.

See also


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The right ventricle is one of four chambers (two atria and two ventricles) in the human heart. It receives de-oxygenated blood from the right atrium via the tricuspid valve, and pumps it into the pulmonary artery via the pulmonary valve.
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respiratory system generally includes tubes, such as the bronchi, used to carry air to the lungs, where gas exchange takes place. A diaphragm pulls air in and pushes it out. Respiratory systems of various types are found in a wide variety of organisms.
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MeSH D017380 Right ventricular hypertrophy (RVH) is a form of ventricular hypertrophy affecting the right ventricle.

Blood travels through the right ventricle to the lungs.
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In medicine, a chronic disease is a disease that is long-lasting or recurrent. The term chronic describes the course of the disease, or its rate of onset and development.
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In medicine, an acute disease is a disease with either or both of:
  1. a rapid onset;
  2. a short course (as opposed to a chronic course).


This adjective is part of the definition of several diseases and is, therefore, incorporated in their name, for instance,
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The term dilation may have a number of meanings:

In physiology, where it is synonymous with dilatation, it may mean:
  • Pupil dilation (mydriasis)
  • Dilation of blood vessels (vasodilation)
  • Cervical dilation (or dilation of the cervix) in childbirth

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Pulmonary circulation is the portion of the cardiovascular system which carries oxygen-depleted blood away from the heart, to the lungs, and returns oxygenated blood back to the heart. The term is contrasted with systemic circulation.
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For other uses of the term "hypoxia", see hypoxia.


Hypoxia is a pathological condition in which the body as a whole (generalised hypoxia) or region of the body (tissue hypoxia) is deprived of adequate oxygen supply.
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Hypoxic pulmonary vasoconstriction is a physiological phenomenon in which pulmonary arteries constrict in the presence of hypoxia (low oxygen levels) without hypercapnia (high carbon dioxide levels), redirecting blood flow to alveoli with higher oxygen tension.
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Systemic may refer to:
  • Any body system in general, usually the nervous system.
  • An insecticide whose mode of action is via uptake into a plant, entering the pest when the plant is consumed.
  • Systemic circulation (as opposed to pulmonary circulation).

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Vasoconstriction is a narrowing of the lumen of blood vessels.

Factors

Factors that trigger vasoconstriction are both of exogenous origin, i.e. medication, and as a response from the body itself.

Body mechanisms

Vasoconstriction is a procedure of the body to e.g.
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Viscosity is a measure of the resistance of a fluid to deform under either shear stress or extensional stress. It is commonly perceived as "thickness", or resistance to flow.
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MeSH D006976 In medicine, pulmonary hypertension (PH) is an increase in blood pressure in the pulmonary artery or lung vasculature, leading to shortness of breath, dizziness, fainting, and other symptoms, all of which are exacerbated by exertion.
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Pulmonary embolism
Classification & external resources

ICD-10 I 26.
ICD-9 415.1

DiseasesDB 10956
MedlinePlus 000132
eMedicine med/1958   emerg/490 radio/582

Pulmonary embolism
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Chronic obstructive pulmonary disease
Classification & external resources

ICD-10 J 40. - J 44. , J 47.
ICD-9 490 - 496

OMIM 606963
DiseasesDB 2672
MedlinePlus 000091
eMedicine med/373   emerg/99

MeSH C08.381.495.
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MeSH D010855 Pierre Robin syndrome (PRS) is a congenital sequence of abnormalities in humans that may occur either as a distinct syndrome or as part of another underlying disorder.
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MeSH D011009 Pneumoconiosis is an occupational lung disease caused by the inhalation of dust. Depending on the type of dust, variants of the disease are considered.

Types include:
  • Coalworker's pneumoconiosis (also known as "black lung") - coal dust

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In human anatomy, the hepatic veins are the blood vessels that drain de-oxygenated blood from the liver and blood cleaned by the liver (from the stomach, pancreas, small intestine and colon) into the inferior vena cava.
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hepatic lobule is a small division of the liver defined at the histological scale. It should not be confused with the anatomic lobes of the liver (caudate lobe, quadrate lobe, left lobe, and right lobe), or any of the functional lobe classification systems.
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Hepatocytes make up 70-80% of the cytoplasmic mass of the liver. These cells are involved in protein synthesis, protein storage and transformation of carbohydrates, synthesis of cholesterol, bile salts and phospholipids, and detoxification, modification and excretion of exogenous
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Nutmeg liver is the pathological appearance of the liver caused by chronic passive congestion of the liver secondary to right heart failure. The liver appears "speckled" like a grated nutmeg kernal, from the dilated, congested central veins (dark spots) and paler, unaffected
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Pulmonary embolism
Classification & external resources

ICD-10 I 26.
ICD-9 415.1

DiseasesDB 10956
MedlinePlus 000132
eMedicine med/1958   emerg/490 radio/582

Pulmonary embolism
..... Click the link for more information.
Thrombolysis is the breakdown (lysis) of blood clots by pharmacological means. It is colloquially referred to as clot busting for this reason. It works by stimulating fibrinolysis by plasmin through infusion of analogs of tissue plasminogen activator, the protein
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Oxygen therapy is the administration of oxygen as a therapeutic modality. Oxygen therapy benefits the patient by increasing the supply of oxygen to the lungs and thereby increasing the availability of oxygen to the body tissues.
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Heart failure
Classification & external resources

ICD-10 I 50.0
ICD-9 428.0

DiseasesDB 16209
MedlinePlus 000158
eMedicine med/3552  
MeSH D006333

Congestive heart failure (CHF), also called
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Pulmonary edema
Classification & external resources

ICD-10 J 81.
ICD-9 514

DiseasesDB 11017
MedlinePlus 000140
eMedicine med/1955   radio/581 Pulmonary edema
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