Chronic cor pulmonale: etiology and management

Article Abstract:

Cor pulmonale is a condition in which the right ventricle (the chamber of the heart that pumps blood to the lungs to receive oxygen) becomes enlarged as a result of diseases of the respiratory system. Hypertrophy (a thicker ventricular wall) and dilatation of the ventricle are usually present in chronic cor pulmonale. Heart failure is not a necessary outcome, but it is a common one, since uncorrected pulmonary hypertension (high pressure in the pulmonary artery) causes both cor pulmonale and heart failure. The main cause of pulmonary hypertension is increased pulmonary vascular resistance, which makes the heart work too hard to pump blood through the lungs. This can result from a variety of disease processes. Its pathogenesis, diagnostic signs, causes, and treatment, are discussed. Treatment usually focuses on relieving the underlying respiratory problem. When the progress of cor pulmonale cannot be stopped, transplantation of lungs or heart, or both, may be performed. This disorder is the third most common cardiac disorder in people older than 50 and its incidence increases in areas where cigarette smoking is common and air pollution is excessive. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Causes of, Heart diseases, Heart enlargement, Heart hypertrophy, Cor pulmonale

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Cardiac asthma - a fresh look at an old wheeze

Article Abstract:

Obstruction and narrowing of breathing passages may be caused by swelling and thickening of the walls of bronchial tubes. The altered blood flow caused by congestive heart failure increases the blood pressure in the bronchial area, compromising the movement of blood away from the bronchial tubes and intensifying the swelling of bronchial tissue. This thickening of the bronchial wall prevents inhalants from being an effective treatment for wheezing in patients who have heart failure (cardiac asthma). Treatment is made more difficult because the bronchial tubes and the blood vessels supplying them do not react uniformly to administered drugs. The effects of drugs which dilate bronchial blood vessels and bronchial tubes were studied in patients who have cardiac asthma as a result of impaired heart function. It was concluded that drugs which dilated the bronchial tubes made the tubes overly responsive. These results differ from those of another study. The conflicting results are attributed to the different patient populations used in the two studies. The effect of drugs which direct their action to blood flow in bronchial tubes is still an important consideration for further studies.

Physiological aspects, Bronchial spasm, Bronchodilator agents, editorial

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Pulmonary hypertension - beyond vasodilator therapy

Article Abstract:

The successful treatment of primary pulmonary hypertension with epoprostanol indicates that this lung disease is not entirely characterized by high blood pressure in the pulmonary blood vessels. A 1998 study found that epoprostanol, also called prostacyclin, improved symptoms in a group of patients with primary pulmonary hypertension. However, this was not entirely due to the drug's dilating effect on blood vessels. High blood pressure in the lungs is often a result of inflammatory disease that blocks blood vessels. Epoprostenol may prevent this inflammatory reaction.

Health aspects, Editorial, Drug therapy, Pulmonary hypertension, Prostacyclin

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