How long can you live with cor pulmonale?

Cor pulmonale is a very serious disease after it occurs. It usually causes many patients to have more or less lesions in their lungs, chest and other organs. As the disease progresses, these symptoms will also become more severe. Therefore, if this disease occurs, the best way is to go to the hospital as soon as possible for diagnosis, and then take the next step of treatment. Remember that you must use the right medicine for the disease.

Clinical manifestations

Chronic cor pulmonale is a heart disease caused by chronic bronchial, lung, thoracic or pulmonary arterial vascular diseases, which leads to increased pulmonary circulatory resistance and pulmonary hypertension, resulting in right heart hypertrophy and enlargement, with or without right heart failure. Acute cor pulmonale is mainly caused by sudden embolism of the main pulmonary artery or its main branches, which blocks most of the pulmonary circulation and leads to a sharp increase in pulmonary artery pressure, acute right ventricular dilatation and right ventricular failure. It is divided into the compensatory stage and the decompensatory stage according to its function.

1. Compensatory stage of lung and heart function (including remission stage)

This stage is mainly characterized by the manifestation of chronic obstructive pulmonary disease (COPD). Chronic cough, sputum, shortness of breath, palpitations after activity, dyspnea, fatigue and decreased work endurance. Physical examination may show obvious signs of emphysema, weakened breath sounds on auscultation, occasional dry and wet rales, and mild edema in the lower limbs, which is obvious in the afternoon and disappears the next morning. The border of cardiac dullness is often difficult to percuss due to emphysema. Heart sounds are distant, but there may be a hyperactive second heart sound in the pulmonary valve area, suggesting pulmonary hypertension. The presence of a systolic murmur in the tricuspid valve area or cardiac pulsation under the xiphoid process often indicates right heart hypertrophy and enlargement. In some cases, emphysema increases the intrapleural pressure, obstructing the vena cava return, and the jugular vein may be seen to be full. As the diaphragm descends, the upper and lower edges of the liver move downward significantly.

2. Decompensated lung and heart function (including acute exacerbation)

The main clinical manifestations of this stage are respiratory failure, with or without heart failure.

examine

1. X-ray examination

In addition to the characteristics of underlying lung and chest diseases and acute lung infection, there may also be signs of pulmonary hypertension, such as dilatation of the right lower pulmonary artery trunk, with a transverse diameter ≥15mm; the ratio of its transverse diameter to the transverse diameter of the trachea ≥1.07; obvious protrusion of the pulmonary artery segment or its height ≥3mm; and signs of right ventricular enlargement, all of which are the main basis for diagnosing cor pulmonale. .

2. Electrocardiogram

The main manifestations include changes in right ventricular hypertrophy, such as right axis deviation, average axis in the frontal plane ≥+90°, severe clockwise rotation, Rv1+Sv5≥1.05mV and pulmonary type P wave. Right bundle branch block and low voltage patterns may also be seen, which can be used as reference conditions for diagnosing cor pulmonale. In V1, V2, and even extending to V3, a QS wave resembling the pattern of a paroxysmal myocardial infarction may appear.

3. Echocardiography

Cor pulmonale can be diagnosed by measuring the inner diameter of the right ventricular outflow tract (≥30mm), the inner diameter of the right ventricle (≥20mm), the thickness of the anterior wall of the right ventricle, the ratio of the inner diameters of the left and right ventricles (<2), the inner diameter of the right pulmonary artery or the enlargement of the pulmonary artery trunk and right atrium.