Symptoms of chronic cor pulmonale

Chronic cor pulmonale is a type of heart disease that develops from chronic bronchitis or emphysema. Chronic cor pulmonale can easily lead to some terrible complications, such as gastrointestinal bleeding and renal insufficiency, so we must actively treat chronic cor pulmonale to avoid worsening of the condition.

If we want to have a deeper understanding of chronic cor pulmonale, we must first recognize the symptoms of chronic cor pulmonale. Only by understanding the symptoms of chronic cor pulmonale can we accurately diagnose the disease when we encounter these symptoms.

The disease is a long-term chronic disease, with gradual signs of lung and heart failure and other organ damage. 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)

The main clinical manifestation of this period is chronic obstructive pulmonary emphysema. Symptoms include coughing, sputum, wheezing, palpitations after activity, shortness of breath, fatigue and decreased work endurance. Physical examination shows obvious signs of emphysema. Due to the increased intrapleural pressure, the vena cava return is obstructed, and the jugular vein is full, the chest is barrel-shaped, the respiratory movement is weakened, the voice tremor is weakened, the breath sounds are reduced, the exhalation is prolonged, wheezing and moist sounds are heard at the lung base, the cardiac dullness boundaries are reduced, the heart sounds are distant, the liver dullness boundaries are decreased, the liver is enlarged and tender, the hepatojugular reflux is positive, there is edema and ascites, etc. Edema of the lower limbs is common, which is obvious in the afternoon and disappears the next morning. There may be a hyperactive second heart sound in the pulmonary valve area, indicating pulmonary hypertension. A systolic murmur in the tricuspid valve area or a cardiac beat under the xiphoid process suggests right ventricular hypertrophy. The descent of the diaphragm causes the upper and lower edges of the liver to move downward significantly, which should be differentiated from the hepatic congestion signs of right heart failure.

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

The main clinical manifestations of this stage are respiratory failure or heart failure.

(1) A common cause of respiratory failure is acute respiratory infection, which is usually ventilatory impairment-type respiratory failure (type II respiratory failure), with hypoxemia and hypercapnia coexisting. Symptoms of hypoxemia include chest tightness, palpitations, shortness of breath, headache, fatigue and abdominal distension. When the arterial oxygen saturation is lower than 90%, obvious cyanosis occurs. People with severe hypoxia may become restless, comatose or have convulsions. At this time, avoid using sedatives or hypnotics to avoid aggravating carbon dioxide retention and causing pulmonary encephalopathy. Hypercapnia is manifested by warm, moist, sweaty skin, dilated superficial veins, surging pulses, conjunctival congestion and edema, pupil constriction, and even exophthalmos, asterixis of the hands, dizziness, headache, drowsiness, and coma. This is the result of vasodilation and increased capillary permeability caused by carbon dioxide retention. When severe respiratory failure is accompanied by mental and neurological disorders and other causes are excluded, it is called pulmonary encephalopathy.

(2) In the functional compensation stage of heart failure cor pulmonale, there are only signs of pulmonary hypertension and right ventricular hypertrophy, but no signs of heart failure. During the decompensation stage, right heart failure, palpitations, shortness of breath, distended neck veins, enlarged liver, lower limb edema, and even systemic edema and peritoneal effusion may occur. A small number of patients may also have left heart failure and arrhythmias.

Above we introduced what chronic cor pulmonale is. We know that chronic cor pulmonale is a common heart disease. Above we introduced the causes of chronic cor pulmonale and the complications that chronic cor pulmonale can easily cause. We also introduced the symptoms of chronic cor pulmonale in detail.