Cor pulmonale: risks, causes and symptoms

The cor pulmonale is a condition characterized by damage to the right side of the heart as a result of severe lung disease. It tends to cause fluid retention and progressive shortness of breath.

Treatment options are very limited as the underlying problem needs to be resolved. If you want to know a little more about this interesting condition, we invite you to read this article.

What symptoms are present?

These depend on the severity of the disease and are the product of both the underlying pulmonary pathology and associated cardiac lesions. Thus, progressive onset respiratory distress (dyspnea) is common.

At first, this can manifest itself during moderate-intensity physical activity, such as walking long distances or climbing stairs. In more serious cases, it could even occur at rest.

Once heart damage begins, there is swelling from fluid build-up (edema) in various parts of the body, such as the lower limbs. Engorgement of the jugular veins, located in the neck, and enlargement of the liver (congestive hepatomegaly) are also common signs.

Main causes of cor pulmonale

The cor pulmonale is caused by a wide variety of diseases that affect the proper functioning of the lungs. This includes both the alteration of the vascular system and the bronchopulmonary tissue.

COPD is one of the primary underlying causes of cor pulmonale.

Chronic obstructive pulmonary disease (COPD)

As its name suggests, this pathology involves progressive lung damage as a result of constant inflammatory reactions. According to the World Health Organization (WHO), it is one of the main causes of mortality worldwide and the most important risk factors for its development are prolonged smoking and exposure to biomass combustion, as occurs when cooking with firewood.

The main symptoms of COPD are dyspnea, productive cough and a tendency to respiratory infections. Lung damage causes less oxygenation of the blood, so patients may require permanent oxygen therapy.

There are several associated comorbidities, being the cor pulmonale one of them. This worsens the prognosis, since the treatment of both conditions is difficult.

Find out more: How is COPD diagnosed?

Cystic fibrosis

It is a disease with a strong genetic component that, despite being capable of affecting several systems, finds the most relevant in the lung. It is characterized by a problem in secretions, especially mucus that occurs naturally in the airways.

This increases the frequency of fatal respiratory infections., such as those produced by Pseudomonas aeruginosa. The damage is usually so obvious that, in most cases, cystic fibrosis is diagnosed in the first months or years of life.

As the disease progresses pulmonary hypertension is common, leading to heart failure. It is common that after the diagnosis cor pulmonale significantly increase mortality in children, as studies indicate.

Scleroderma

This term is used to describe a group of disorders that cause fibrosis and progressive failure in almost any organ. Fibrosis is a repair process that generates tissues without a specific function.

Dermatological reactions are the most frequent, despite the lung being one of the most affected internal organs. This produces diffuse interstitial lung disease and, as in the previous case, also leads to pulmonary hypertension.

From an epidemiological point of view, scleroderma usually affects women between the ages of 30 and 50. Although there is no definitive cure, treatment is aimed at alleviating symptoms and reducing associated inflammatory phenomena.

How is cor pulmonale diagnosed?

Doctors use a combination of clinical and paraclinical elements to make the diagnosis. From an anatomical point of view, cardiac lesions in the cor pulmonale affect a cavity called Right ventricle and are called hypertrophy Y dilatation.

The first involves an increase in the thickness of the walls of the cavity, while the second refers to an increase in the size of the ventricle.

These can be suspected by a simple chest x-ray and an electrocardiogram. It is then confirmed with an ecosonogram or nuclear magnetic resonance.

Pulmonary hypertension that occurs initially is confirmed by right heart catheterization. This technique consists of inserting a thin tube through a vein in the groin region, neck or arm. It moves to the right side of the heart to measure its pressure.

Keep reading: How to diagnose heart disease?

Available treatments

The oxygen requirement in this condition is variable, but it can start from infancy in cystic fibrosis, for example.

Therapy is complicated in most patients, which explains the high associated mortality. As the cor pulmonale It is a pathology secondary to another condition, the most effective approach involves eliminating or reducing those alterations that are causing the heart damage. This can become impossible in severe cases, unless a lung transplant is performed.

Depending on the clinical context of the patient, some medications may be administered to alleviate symptoms related to fluid retention. Diuretic drugs are helpful, although there are some contraindications that the doctor must assess.

Although pulmonary hypertension can be treated with several medications (such as pulmonary vasodilators), these are usually not effective for the diseases that cause the cor pulmonale as a complication.

Cor pulmonale prevention

To prevent this complication, just avoid risk factors for pulmonary pathologies. Some effective habits are as follows:

  • Progressively eliminate tobacco addiction.
  • Do not cook with firewood.
  • Avoid occupational exposure to toxic substances such as silica, asbestos, and beryllium.

The cor pulmonale it is a serious condition that requires timely medical evaluation. In case of presenting any of the aforementioned symptoms, it is advisable to go to a specialist as soon as possible. Cardiologists are the professionals indicated for this.