PATHOPHYSIOLOGY of COR PULMONALE

Precipitating Factors: Predisposing Factors:

y y y Age Sex (Male) Heredity Etiology (Unknown) y y y y y Lifestyle Diet COPD History of MI History of CAD

Hypoxia and hypoxemia

Respiratory Acidosis

Hypoxic Pulmonary Arterial vasoconstriction

Decrease in pulmonary vascular bed

Increase pulmonary artery pressure

Increase resistance in pulmonary circulatory system

Pulmonary hypertension

Increased right ventricular afterload

loud second heart sound

Right ventricular hypertrophy

Enlarged heart

Right ventricular failure

Increased venous pressure

Increased capillary hydrostatic pressure throughout the venous system

Further impairment of blood circulation

a b

Jugular venous distension

Retention of fluid Easy fatigability Edema of the lower extremities confusion

Distended neck veins

Enlarged palpable liver Increase pressure within the portal vessels

Increase pressure on the diaphragm

Somnolence

Shortness of breath

Ascites