Risks, Causes And Symptoms Of Cor Pulmonale

Today we are going to talk about the risks, causes and symptoms of cor pulmonale. Cor pulmonale is a condition characterized by damage to the right side of the heart from severe lung disease. It causes fluid retention and progressive respiratory distress.

Therapeutic options are limited, as it is necessary to solve the underlying problem. Read on to learn more about this interesting condition.

The symptoms of cor pulmonale

The symptoms of cor pulmonale depend on the severity of the disease and are the product of both the underlying lung disease and associated heart lesions. It is therefore common in people with breathing difficulties (dyspnea) that start progressively.

Initially, this may occur during moderate-intensity physical activity, such as walking long distances or climbing stairs. It can even occur during rest in more severe cases.

Once heart damage begins, there is swelling due to fluid buildup (edema) in various parts of the body, such as the legs. Engorgement of the jugular veins located in the neck and enlargement of the liver (congestive hepatomegaly) are also common symptoms.

Main causes of cor pulmonale

This condition is due to a wide variety of diseases that affect the proper functioning of the lungs. This includes disruption of the vascular system as well as bronchopulmonary tissue.

Chronic Obstructive Pulmonary Disease (COPD)

As the name suggests, this condition is associated with progressive lung damage due to constant inflammatory responses. According to the World Health Organization (Spanish link), it is one of the leading causes of death worldwide.

The main risk factors for its development are long-term smoking and exposure to biomass combustion. The latter occurs when cooking on wood.

The main symptoms of COPD are shortness of breath, productive cough and a tendency to respiratory infections. Lung damage results in decreased oxygenation of the blood and may require permanent oxygen therapy.

There are several additional comorbidities, including cor pulmonale. This worsens the prognosis, as the treatment of both conditions is very difficult.

Cystic fibrosis

This is a disease with a strong genetic component that, despite the fact that it can affect multiple systems, is most relevant in the lung area. The main characteristic problems are secretions, especially in the mucus produced naturally in the respiratory tract.

As you can imagine, this increases the frequency of deadly respiratory infections, such as those caused by Pseudomonas aeruginosa. The damage is usually so obvious that cystic fibrosis is most often diagnosed in the first months or years of life.

As the disease progresses, it is common for pulmonary hypertension to develop and lead to heart failure. According to studies, there is also an overall mortality rate in children diagnosed with cor pulmonale.

Scleroderma

This term describes a group of conditions that cause fibrosis and progressive failure in almost every organ. Fibrosis is a repair process in which tissues are created without a specific function.

Dermatological reactions are the most common, despite the fact that the lung is one of the most affected internal organs. It leads to diffuse interstitial lung disease and also leads to pulmonary hypertension, as in the previous case.

From an epidemiological point of view, scleroderma most often affects women between the ages of 30 and 50. There is no definitive cure and treatment aims to relieve symptoms and reduce associated inflammation.

Diagnosis of cor pulmonale

Doctors use a combination of clinical and paraclinical elements to make a diagnosis. The heart lesions in the cor pulmonale affect a cavity, the right ventricle and anatomy refers to it as hypertrophy and dilation.

The former refers to an increase in the thickness of the walls of the cavity, while the latter refers to an increase in the size of the ventricle. These can be seen through a simple chest X-ray and electrocardiogram. It is then confirmed with an ultrasound sonogram or via magnetic resonance imaging.

Pulmonary hypertension that occurs initially is confirmed by a cardiac catheterization (Spanish link). This technique consists of inserting a thin tube through a vein in the groin area, neck, or arm. The technician switches it to reach the right side of the heart to measure the pressure.

Available treatments

The oxygen demand in this condition varies, but can start early in children with cystic fibrosis. The therapy is complicated in most patients, which explains the associated high mortality.

Since cor pulmonale is secondary to another condition, the most effective approach is to eliminate or reduce the factors that cause heart damage. This may be impossible in severe cases and may require a lung transplant.

Depending on the patient’s clinical context, there are medications to relieve symptoms related to fluid retention. Diuretics are useful, although there are some contraindications that the attending physician should assess.

There are many medications to treat pulmonary hypertension (such as pulmonary vasodilators). These are usually ineffective for diseases that cause cor pulmonale as a complication.

Prevention of cor pulmonale

It is enough to avoid the risk factors for pulmonary pathologies to prevent this condition. Some effective healthy habits include:

• Stop smoking gradually.
• Do not cook with firewood.
• Avoid occupational exposure to toxic substances such as silica, asbestos and beryllium.

Cor pulmonale is a serious condition that requires immediate medical evaluation. Consult a specialist as soon as possible if any of the above symptoms are present. Cardiologists are the professionals you should visit for this purpose.