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COR PULMONALE

COR PULMONALE. OBJECTIVES. review the anatomy and physiology of the respiratory system review the anatomy and physiology of the cardiovascular system interpret the term cor pulmonale describe the etiology of cor pulmonale. OBJECTIVES CONTINUED ….

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COR PULMONALE

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  1. COR PULMONALE

  2. OBJECTIVES • review the anatomy and physiology of the respiratory system • review the anatomy and physiology of the cardiovascular system • interpret the term corpulmonale • describe the etiology of corpulmonale

  3. OBJECTIVESCONTINUED…... • discuss the pathogenesis involved in the disease process • examine the clinical manifestations closely • differentiate the various diagnostic measures • explain the medical management

  4. OBJECTIVESCONTINUED…... • identify the surgical management of corpulmonale • distinguish the nursing management for corpulmonale including the nursing diagnosis • obtain knowledge on the prognosis of corpulmonale

  5. REVIEW OF ANATOMY & PHYSIOLOGY RESPIRATORY SYSTEM

  6. UPPER RESPIRATORY TRACT

  7. LOWER RESPIRATORY TRACT

  8. LOWER RESPIRATORY TRACT

  9. RESPIRATORY PROCESS

  10. CARDIOVASCULAR SYSTEM

  11. HEART WALLS AND LAYERS

  12. CHAMBERS OF THE HEART

  13. VALVES OF THE HEART

  14. CORONARY ARTERIES

  15. HEART RATES • NORMAL HEART RATE • SINUS TACHYCARDIA

  16. HEART RATES • SINUS BRADYCARDIA

  17. COR PULMONALE

  18. DEFINITION It is the hypertrophy of the right ventricle resulting from diseases affecting the function and/or structure of the lung, except when these pulmonary alterations are the result of diseases that primarily affect the left side of the heart or congenital heart disease(WHO, 1963)

  19. DEFINITION It is the enlargement of the right ventricle secondary to diseases of the lung , thorax, or pulmonary circulation. Pulmonary hypertension is usually a pre-existing condition in the individual with corpulmonale. The most common cause is COPD. (lewis)

  20. DEFINITION It is a condition in which the right ventricle of the heart enlarges (with or without right sided heart failure) as a result of diseases that affect the structure or function of the lung or its vasculature

  21. ETIOLOGY • Conditions that restrict or compromise ventilatoryfunction, leading to hypoxemia or acidosis e.g. deformities of the thoracic cage, massive obesity • Conditions that reduce the pulmonary vascular bed e.g. primary idiopathic pulmonary arterial hypertension, pulmonary embolus

  22. ETIOLOGY • Disorders involving nervous system, respiratory muscles, chest wall , and pulmonary arterial tree may also be responsible for corpulmonale

  23. PATHOGENESIS GENETICCAUSES UNKNOWN CAUSES

  24. PATHOGENESIS CONTINUED…… PULMONARY ENDOTHELIAL INJURY

  25. PATHOGENESIS CONTINUED…… VASOCONSTRICTION REMODELLING

  26. PATHOGENESIS CONTINUED…… SUSTAINED PULMONARY HYPERTENSION RIGHT VENTRICULAR HYPERTROPHY

  27. PATHOGENESIS CONTINUED…… COR PULMONALE

  28. PATHOPHYSIOLOGIC CLASSIFICATION PERSISTENT VASOCONSTRICTION • High altitude dwellers • Hyperventilation syndromes • Chest deformities • Idiopathic pulmonary hypertension

  29. PATHOPHYSIOLOGIC CLASSIFICATION LOSS OF CROSS SECTIONAL AREA OF THE VASCULAR BED • Thromboembolic disease • Emphysema • Lung resection • Fibrotic lung disease • Cystic fibrosis

  30. PATHOPHYSIOLOGIC CLASSIFICATION OBSTRUCTION OF LUNG VESSELS • Extrinsic compression of the pulmonary veins • Fibrosingmediastinitis • Adenopathy or tumors • Pulmonary veno-occlusive disease

  31. PATHOPHYSIOLOGIC CLASSIFICATION CHRONICALLY INCREASED BLOOD FLOW EISENMENGER SYNDROME

  32. PATHOPHYSIOLOGIC CLASSIFICATION VASCULAR REMODELLING • Primary pulmonary hypertension • Secondry pulmonary hypertension • Collagen vascular diseases • Cystic fibrosis

  33. CLINICAL MANIFESTATIONS • Dyspnea • Chronic productive cough • Wheezing respirations • Retrosternal or substernal pain • Fatigue • Polycythemia

  34. CLINICAL MANIFESTATIONS If heart failure accompanies corpulmonale additional manifestations such as • Peripheral edema • Weight gain • Distended neck veins • Full bounding pulse • Enlarged liver

  35. CLINICAL MANIFESTATIONS • Palpitation • Atypical chest pain • Swelling of the lower extremities • Dizziness and even syncope

  36. DIAGNOSIS • HISTORY COLLECTION

  37. DIAGNOSIS • PHYSICAL EXAMINATION

  38. DIAGNOSIS • LABORATORY TESTS • ABG ANALYSIS • BRAIN NATRIURETIC PEPTIDE

  39. DIAGNOSIS • PULMONARY FUNCTION TEST • CHEST RADIOGRAPHY

  40. DIAGNOSIS • ELECTROCARDIOGRAPHY • ECHOCARDIOGRAPHY

  41. DIAGNOSIS • PULMONARY THROMBOEMBOLISM IMAGING STUDIES • ULTRAFAST, ECG-GATED CT SCANNING

  42. DIAGNOSIS • MAGNETIC RESONANCE IMAGING • NUCLEAR IMAGING

  43. DIAGNOSIS • CARDIAC CATHETERIZATION

  44. DIAGNOSIS • LUNG BIOPSY

  45. MEDICAL MANAGEMENT • OXYGEN THERAPY

  46. MEDICAL MANAGEMENT • PHARMACOTHERAPY • DIURETIC AGENTS • VASODIALATORS • BETA SELECTIVE AGONISTS • CARDIAC GLYCOSIDES • THEOPHYLLINE • WARFARIN

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