Manifestations of Cor Pulmonale

Written by Li Tao
Pulmonology
Updated on September 21, 2024
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Cor pulmonale refers to a disease characterized by changes in heart structure and function due to increased pulmonary vascular resistance caused by pathological conditions of the bronchi, lungs, thoracic cage, or pulmonary vessels, leading to pulmonary arterial hypertension. This condition is collectively known as cor pulmonale. The clinical manifestations of cor pulmonale generally develop slowly. Clinically, in addition to pulmonary and pleural symptoms, there gradually appear signs of pulmonary cardiac failure and damage to other organs. Common symptoms include coughing, expectoration, palpitations, dyspnea, fatigue, decreased endurance to physical activity. In the decompensated stage, symptoms such as worsening dyspnea, headaches, insomnia, decreased appetite, and even some signs of right heart failure like palpitations, poor appetite, abdominal bloating, nausea, and swelling of the lower limbs may occur.

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Complications of cor pulmonale commonly include several conditions. The first is pulmonary encephalopathy, caused by respiratory failure leading to hypoxia and carbon dioxide retention, which can cause somnolence in patients and, in severe cases, lead to coma. The second is acid-base imbalance and electrolyte disturbances. Cor pulmonale may present with various electrolyte disturbances, such as hyponatremia and hypokalemia. The third is arrhythmias, most commonly manifesting as atrial premature beats or paroxysmal supraventricular tachycardia. The fourth complication is shock. Shock is not very common in cor pulmonale, but if it occurs, the prognosis is poor.

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