LECTURE No. 36. Chronic cor pulmonale

Hypertrophy and (or) dilatation of the right heart due to pulmonary arterial hypertension due to a respiratory disease.

Etiology. Etiological factors include bronchopulmonary disorders - obstructive and restrictive processes: polycystic lung disease, chronic bronchitis, bronchial asthma, pulmonary emphysema, diffuse pneumofibrosis, pulmonary granulomatosis, vascular lesions - primary pulmonary arterial hypertension, arteritis, repeated pulmonary vascular embolism, lung resection, thoracic lesions -diaphragmatic apparatus; lesions of the spine, chest, their deformation, pleural moorings, obesity.

Pathogenesis. Pathogenetic stages: precapillary hypertension in the pulmonary circulation, right ventricular hypertrophy, right ventricular heart failure, development of pulmonary arterial hypertension, an increase in cardiac output due to an increase in catecholamines caused by hypoxia, an increase in blood viscosity due to erythrocytosis in response to chronic hypoxia, the development of bronchopulmonary anastomoses, an increase in intraalveolar pressure in broncho-obstructive lung diseases.

Classification. The disease is classified as follows:

1) by etiology: bronchopulmonary, thoracophrenic, vascular;

2) downstream: acute (minutes, hours), subacute (days, weeks), chronic (months, years);

3) according to the degree of compensation: compensated, decompensated.

Clinic. The main manifestations of the disease are the following: shortness of breath, cyanosis (appears with II and III degrees of respiratory failure), swelling of the jugular veins, epigastric pulsation, tachycardia, expansion of the boundaries of the heart, especially to the right, deafness of heart tones, emphasis of the II tone over the pulmonary artery, increase and soreness liver, peripheral edema, small diuresis (in a decompensated state).

Additional diagnostic study. A complete blood count (erythrocytosis, normal or reduced ESR), a general urinalysis (the appearance of protein, cylinders during decompensation), a biochemical blood test (dysproteinemia), a functional study of the lungs (allows to distinguish between the degree of respiratory failure) are carried out. On the ECG - signs of cor pulmonale: high P waves in II and III standard leads (P - pulmonale), rightogram, pronounced S wave in I standard lead and left chest leads, the appearance of Q in lead III. A study of hemodynamics is carried out (increased central venous pressure, slowing down the speed of blood flow, increasing the volume of circulating blood). On echocardiography: an increase in thickness in the compensated state and cavity in the decompensated state of the right ventricle. An X-ray examination is also carried out.

Complications. Complications of the disease are pulmonary-cardiac coma (hypercapnic encephalopathy), cough-fainting syndrome (loss of consciousness with convulsions), gastric and duodenal ulcers.

Treatment. Treatment is aimed at treating the underlying disease. In case of infection of the bronchopulmonary apparatus, antibiotics are used, in case of broncho-obstruction - bronchodilators, in case of PE - anticoagulants, fibrinolytic drugs, in case of thoracodiaphragmatic pulmonary heart - artificial ventilation of the lungs. Peripheral vasodilators are used to reduce pulmonary arterial hypertension (nitrates, apressin, calcium channel blockers, β₂adrenomimetics). Oxygen therapy is carried out, bloodletting of 200-300 ml with infusion of low-viscosity solutions (rheopolyglucin) to reduce erythrocytosis, infusion of sodium bicarbonate solution to reduce acidosis. Diuretics are administered, it is possible to use diuretics of different classes simultaneously, vasodilators, antiplatelet drugs, non-steroidal anabolic agents (ATP, riboxin). Remedial gymnastics, massage, postural drainage are shown.

Prevention. Prevention is the prevention and timely treatment of respiratory diseases.

Flow. The course of the disease is chronic and progressive.

Forecast. Adverse.

Author: Myshkina A.A.

<< Back: Sarcoidosis (Besnier-Beck-Schaumann disease)

>> Forward: Pleurisy

We recommend interesting articles Section Lecture notes, cheat sheets:

▪ Marketing. Lecture notes

▪ Jurisprudence. Crib

▪ State and municipal administration. Crib

See other articles Section Lecture notes, cheat sheets.

Read and write useful comments on this article.

<< Back

Latest news of science and technology, new electronics:

The existence of an entropy rule for quantum entanglement has been proven 09.05.2024

Quantum mechanics continues to amaze us with its mysterious phenomena and unexpected discoveries. Recently, Bartosz Regula from the RIKEN Center for Quantum Computing and Ludovico Lamy from the University of Amsterdam presented a new discovery that concerns quantum entanglement and its relation to entropy. Quantum entanglement plays an important role in modern quantum information science and technology. However, the complexity of its structure makes understanding and managing it challenging. Regulus and Lamy's discovery shows that quantum entanglement follows an entropy rule similar to that for classical systems. This discovery opens new perspectives in the field of quantum information science and technology, deepening our understanding of quantum entanglement and its connection to thermodynamics. The results of the study indicate the possibility of reversibility of entanglement transformations, which could greatly simplify their use in various quantum technologies. Opening a new rule ... >>

Mini air conditioner Sony Reon Pocket 5 09.05.2024

Summer is a time for relaxation and travel, but often the heat can turn this time into an unbearable torment. Meet a new product from Sony - the Reon Pocket 5 mini-air conditioner, which promises to make summer more comfortable for its users. Sony has introduced a unique device - the Reon Pocket 5 mini-conditioner, which provides body cooling on hot days. With it, users can enjoy coolness anytime, anywhere by simply wearing it around their neck. This mini air conditioner is equipped with automatic adjustment of operating modes, as well as temperature and humidity sensors. Thanks to innovative technologies, Reon Pocket 5 adjusts its operation depending on the user's activity and environmental conditions. Users can easily adjust the temperature using a dedicated mobile app connected via Bluetooth. Additionally, specially designed T-shirts and shorts are available for convenience, to which a mini air conditioner can be attached. The device can oh ... >>

Energy from space for Starship 08.05.2024

Producing solar energy in space is becoming more feasible with the advent of new technologies and the development of space programs. The head of the startup Virtus Solis shared his vision of using SpaceX's Starship to create orbital power plants capable of powering the Earth. Startup Virtus Solis has unveiled an ambitious project to create orbital power plants using SpaceX's Starship. This idea could significantly change the field of solar energy production, making it more accessible and cheaper. The core of the startup's plan is to reduce the cost of launching satellites into space using Starship. This technological breakthrough is expected to make solar energy production in space more competitive with traditional energy sources. Virtual Solis plans to build large photovoltaic panels in orbit, using Starship to deliver the necessary equipment. However, one of the key challenges ... >>

Random news from the Archive Submarine powered by lithium-ion batteries 09.10.2018 Japan's Mitsubishi Corporation launched the diesel-electric submarine Oryu at its shipyard in Kobe, Japan's first lithium-ion battery-powered submarine. Underwater displacement of the new Soryu-class Oryu submarine is 4200 tons, the hull length reaches 84 meters, width - 9,1 meters. The submarine is equipped with a pair of diesel engines and four Stirling engines, necessary to power the propulsion electric motors and charge the batteries in a submerged position. The Oryu is capable of a top speed of 20 knots and can stay submerged for up to three months. Stirling engines operate in a submerged position due to the combustion of diesel fuel, and the products of its combustion are thrown into the water jet from the propellers. Batteries are necessary for diesel-electric submarines for covert movement, when running diesel engines to power electric motors is highly undesirable. As a rule, lead-acid batteries are used for these purposes, but they are heavy, do not have a large capacity and take a long time to charge. Lithium-ion batteries have a large capacity, provide a significant increase in the range of the submarine and charge much faster than lead-acid ones. At low speeds, the underwater range of such a submarine is similar to the power reserve on lead-acid batteries and a Stirling engine. In the near future, Oryu will begin testing, and in March 2020 it will be handed over to the Japan Maritime Self-Defense Force.

Other interesting news:

▪ big data transfer record

▪ Razer Cobra Pro Wireless Gaming Mouse

▪ Logitech Webcam C930e

▪ Panel thermostats series 7T81 from Finder

▪ Supercapacitors made from cigarette butts

News feed of science and technology, new electronics

Interesting materials of the Free Technical Library:

▪ site section Spectacular tricks and their clues. Article selection

▪ article Classification of plants. History and essence of scientific discovery

▪ article What are moles? Detailed answer

▪ Article Project Manager. Job description

▪ article Electronic fishing rod-mormyshka. Encyclopedia of radio electronics and electrical engineering

▪ article Welding small-sized. Encyclopedia of radio electronics and electrical engineering

Leave your comment on this article:

All languages ​​of this page

Arabic	Hebrew	Polish
Bengali	Hindi	Portuguese
Chinese	Italian	Spanish
English	Japanese	Turkish
French	Korean	Ukrainian
German	Malay	Vietnamese

Home page | Library | Articles | Website map | Site Reviews

www.diagram.com.ua
2000-2024