Cor pulmonale: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
===Blood tests=== | |||
*CBC (polycythemia) | |||
*ABG (oxygenation, acid-base status) | |||
*alpha-1-antitrypsin | |||
*ANA | |||
*Coagulation studies (protein C/S, factor V Leiden etc) | |||
===CXR=== | |||
*Enlarged pulmonary arteries | |||
*Cardiomegaly | |||
*Decreased retrosternal air space | |||
===EKG=== | |||
*RVH | |||
*Right axis deviation | |||
*RBBB | |||
*R:S ratio > 1 in V1 | |||
*Large P wave in II, III, aVF | |||
*Arrhythmia (PAC, SVT, MFAT, A-fib, A-flutter) | |||
==Management== | ==Management== | ||
Revision as of 06:17, 9 September 2015
Background
- Remodeling of right ventricle in response to pulmonary pathology
- Often caused by COPD, pulmonary hypertension, PE, ARDS
Clinical Features
Pathophysiology
- Pulmonary vasoconstriction (hypoxia, acidemia)
- Destruction of pulmonary vasculature by emphysema, ILD
- Increased blood viscosity (sickle cell, polycythemia)
Chronic
- RVH
Acute
- RV dilation
Signs and Symptoms
- Cough
- Dyspnea
- Tachypnea
- Hemoptysis
- Syncope
- Peripheral edema
- Cyanosis
Differential Diagnosis
Diagnosis
Blood tests
- CBC (polycythemia)
- ABG (oxygenation, acid-base status)
- alpha-1-antitrypsin
- ANA
- Coagulation studies (protein C/S, factor V Leiden etc)
CXR
- Enlarged pulmonary arteries
- Cardiomegaly
- Decreased retrosternal air space
EKG
- RVH
- Right axis deviation
- RBBB
- R:S ratio > 1 in V1
- Large P wave in II, III, aVF
- Arrhythmia (PAC, SVT, MFAT, A-fib, A-flutter)