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Pulmonary heart disease causes, symptoms, treatment & complication

pulmonary heart disease
Contents

Overview

Pulmonary heart disease, also called cor pulmonale, is enlargement and failure of the right side of the heart caused by high blood pressure in the lungs (pulmonary hypertension). It is usually the result of a lung disease. It can be acute or chronic.

Acute Pulmonary Heart Disease

Acute cor pulmonale develops suddenly, most often from a large blood clot in the lungs. Unlike most heart disease causes, the problem starts in the lungs: the sudden rise in lung pressure stretches (dilates) the right ventricle.

Chronic Pulmonary Heart Disease

Chronic pulmonary heart disease develops over months or years and causes right ventricular hypertrophy, a thickening of the heart muscle. Because the right ventricle has to pump against high pressure in the lungs for a long time, its muscle grows thicker to cope.

In pulmonary hypertension, the small arteries in the lungs (pulmonary arterioles) and capillaries become narrowed, stiff or blocked. This makes it harder for blood to flow through the lungs and raises the pressure in the pulmonary arteries.

The right ventricle has to work harder to push blood through the lungs. Over time it weakens and fails, and blood backs up in the veins, causing swelling in the legs and belly.

Causes of Pulmonary Heart Disease

According to MedlinePlus, lung disease is the usual cause. Common causes include

  • Pulmonary arterial hypertension
  • COPD
  • Blood clots in lungs
  • Sickle cell anemia
  • Acute respiratory distress syndrome
  • Kyphoscoliosis
  • Sleep apnea
  • Pulmonary fibrosis
  • Cystic fibrosis
  • Pulmonary artery stenosis
  • Pulmonary vein stenosis
  • Interstitial lung disease
  • Long term exposure to high altitude
  • Severe bronchiectasis
  • Severe obesity

Signs & Symptoms Related To Pulmonary Heart Disease

Shortness of breath or lightheadedness during activity is often the first symptom. Over time, symptoms appear with less effort or even at rest. Signs and symptoms can include

Get emergency care for sudden severe shortness of breath, chest pain or fainting.

How We Can Diagnose The Cor Pulmonale?

Your doctor will examine you and ask about your symptoms. Tests may include:

  • ECG: may show strain or thickening of the right side of the heart, a peaked P wave or arrhythmias.
  • Chest X-ray: may show enlarged pulmonary arteries and an enlarged right side of the heart.
  • Echocardiogram: an ultrasound of the heart that shows how well the right ventricle is working and estimates lung pressures.
  • Right heart catheterization: measures pressure in the lungs directly and confirms pulmonary hypertension.
  • Chest CT scan, ventilation and perfusion (V/Q) scan and lung function tests: look for lung disease and blood clots.
  • Blood tests, including arterial blood gas to check oxygen levels and tests for autoimmune lung disease.

Treatment Plan to Cure the Pulmonary Heart Disease

Chronic cor pulmonale usually cannot be cured, but treatment can control symptoms and slow it down. The most important step is treating the condition that causes the high lung pressure. Treatment may include:

  1. Treating the underlying lung disease, for example COPD or sleep apnea.
  2. Antibiotics to treat chest infections that can make it worse.
  3. Oxygen therapy, since oxygen levels are low in most people with cor pulmonale.
  4. Diuretics ("water pills") to reduce fluid buildup and swelling.
  5. Medicines for pulmonary hypertension that relax and widen the lung arteries, for some causes.
  6. Blood thinners (anticoagulants) to treat or prevent blood clots.
  7. A lung or heart-lung transplant if medicines do not work.

Medicines and doses are chosen by your doctor based on the cause and severity. MedlinePlus also advises getting yearly flu and other recommended vaccines, stopping smoking, limiting salt and avoiding high altitudes.

COMPLICATIONS

If pulmonary heart disease is undiagnosed, untreated or keeps getting worse, it can cause life-threatening complications, including:

  • Severe, life-threatening shortness of breath
  • Severe fluid buildup in the body
  • Right-sided heart failure
  • Arrhythmias
  • Blood clots
  • Shock and death

HP Thoughts: We would like to introduce you this time to the heart of our discussion (no pun intended). Read our article to learn more: Heart Anatomy.

Sources

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