Cor pulmonale: Approach it this way.

Cor pulmonale: Approach it this way.

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DEFINITION

Cor pulmonale is failure of the right side of the heart due to lung dysfunction caused by emphysema, silicosis, or other severe lung disease.

CAUSE

The heart and the lungs are close in anatomical position and function. Reserves of blood in the lungs, and the lungs' ability to move that blood through the circulatory system and assist the heart's functions during violent exertion, tie the heart and lungs together as an integrated system.

Normally, the pressure on the right side of the heart is much lower than the left, since the pressure required to push blood through the lungs is much less than that required to pump blood to the rest of the body. The lungs not only keep the blood well oxygenated, they also produce and inactivate substances that control circulation.

When the lungs fail and the blood is not well oxygenated, the blood vessels in the lung constrict. Initially this may be protective, since it will divert blood from poorly ventilated or diseased portions of lung to healthy portions. However, if too many pulmonary blood vessels constrict, it puts excessive load on the right side of the heart, the part responsible for pumping blood into the lungs.

As the pressure required to pump the blood through the constricted blood vessels increases, the heart muscle becomes overdeveloped to compensate. Eventually, the load on the heart becomes too great, causing failure of the right side of the heart.

DIAGNOSIS

Outward signs of this problem include swelling (edema) of the liver, abdomen, and lower extremities.

TREATMENT

An MD came here for three days and increased his breathing volume 17% more than he has been able to do in 30 years.

Treating and reversing the underlying lung disease and improving the oxygenation of the blood are an essential first step. In addition, diuretics may reduce edema. This will require a medical professional schooled in respiratory therapy. I suggest you also get our Shortness of Breath Program or come to Charlotte.

 


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