Complication of COPD

Complication
• Respiratory Failure (RF)
– Chronic RF  PO2 < 60 mmHg; PCO2 > 60 mmHg;
normal pH
– Acute on chronic RF  dypsnea, increase sputum
and purulen, fever, altered mental state
• Recurrent infection  due to increase sputum
production
• Cor pulmonale  P pulmonal on ECG,
hematocrit > 50 %
 COPD

Hypoxemia, hypercapnea, acidosis

Pulmonary vasoconstriction

Pulmonary Hypertension

Increase RV afterload

RVH
 Symptoms (1)
• Fatigue
• Tachypnea
• Exertional dyspnea
• Cough
• Anginal chest pain  due to right ventricular
ischemia (it usually does not respond to nitrates)
or pulmonary artery stretching
• Hemoptysis  rupture of a dilated or
atherosclerotic pulmonary artery
 Symptoms (2)
• Hoarseness
• Anorexia, right upper quadrant abdominal
discomfort, and jaundice (passive hepatic
congestion secondary to severe right ventricular
failure)
• Syncope with exertion (relative inability to
increase cardiac output during exercise)
• Peripheral edema (increase the hydrostatic
gradient)
 Reference
• PPOK (PEDOMAN DIAGNOSIS &
PENATALAKSANAAN DI INDONESIA) PDPI
1997-2003
• Global Initiative for COLD (GOLD updated
2010)
• http://emedicine.medscape.com/article/807
143-clinical