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    Cor Pulmonale

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    drnareshkumar3281
    This document describes a case of cor pulmonale, including a list of symptoms, possible causes, examination findings, tests to be ordered, potential treatments including medications, surgery, oxygen therapy, and follow up. Cor pulmonale is heart failure caused by lung disease that puts pressure on the right side of the heart.

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    Cor Pulmonale

    Uploaded by

    drnareshkumar3281
    275 views6 pages
    This document describes a case of cor pulmonale, including a list of symptoms, possible causes, examination findings, tests to be ordered, potential treatments including medications, surgery, oxygen therapy, and follow up. Cor pulmonale is heart failure caused by lung disease that puts pressure on the right side of the heart.

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    © Attribution Non-Commercial (BY-NC)

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    This document describes a case of cor pulmonale, including a list of symptoms, possible causes, examination findings, tests to be ordered, potential treatments including medications, surgery, oxygen therapy, and follow up. Cor pulmonale is heart failure caused by lung disease that puts pressure on the right side of the heart.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    275 views6 pages

    Cor Pulmonale

    Uploaded by

    drnareshkumar3281
    This document describes a case of cor pulmonale, including a list of symptoms, possible causes, examination findings, tests to be ordered, potential treatments including medications, surgery, oxygen therapy, and follow up. Cor pulmonale is heart failure caused by lung disease that puts pressure on the right side of the heart.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 6

    COR PULMONALE

    CHIEF COMPLAINT

    Cor pulmonale

    HPI

    SYMPTOM LIST

    • Fatigue
    • Tachypnea
    • Exertional dyspnea
    • Cough
    • Angina
    • Chest pain
    • Hemoptysis
    • Hoarseness
    • Anorexia
    • Right upper quadrant abdominal discomfort
    • Syncope
    • Peripheral edema

    SEVERITY
    • Mild
    • Moderate
    • Severe
    • Absent
    • Normal
    • Increased
    • Decreased
    • Stable
    • no significant change from prior visit

    HISTORY (PMFSH)

    PAST HISTORY

    • Massive pulmonary embolization


    • Exacerbation of chronic cor pulmonale
    • COPD
    • Loss of lung tissue following trauma or surgery
    • Pierre Robin sequence
    • End stage Pneumoconiosis
    • Sarcoidosis
    • Repeated pulmonary emboli
    • Pulmonary vasculitis
    • Pulmonary veno-occlusive disease
    • Congenital heart disease with left-to-right shunting
    • Sickle cell disease
    • High altitude disease with pulmonary vasoconstriction
    • Primary pulmonary hypertension
    • Interstitial lung diseases
    • Chronic obstructive lung diseases
    • Neuromuscular disorders
    • Myasthenia gravis
    • Poliomyelitis
    • Amyotrophic lateral sclerosis
    • Obstructive and central sleep apnea
    • Kyphoscoliosis
    • Diabetes
    • Hypertension
    • Cancers

    ALLERGY-Drugs
    -Environment

    FAMILY HISTORY

    • Diabetes
    • Hypertension
    • Heart diseases
    • Connective tissue diseases
    • Sarcoidosis
    • COPD

    SOCIAL HISTORY

    Habits

    • Alcohol
    • Tobacco
    • Drugs___
    Occupation____

    ROS

    PHYSICAL EXAMINATION

    On Inspection
    • An increase in chest diameter
    • Labored respiratory efforts with retractions of chest wall
    • Distended neck veins with prominent a or v waves
    • Cyanosis
    On Auscultation of the lungs
    • Wheezes
    • Crackles
    • Systolic bruits in the lungs.
    On Auscultation of the heart
    • Splitting of the second heart sound with accentuation of the
    pulmonic component
    • Systolic ejection murmur with sharp ejection click
    • Diastolic pulmonary regurgitation murmur
    • Third and fourth sounds of the heart
    • Systolic murmur of tricuspid regurgitation.
    • A left parasternal
    • A left subxiphoid heave
    • Hepatojugular reflex
    • Pulsatile liver
    On Percussion
    • Hyper resonance of the lungs
    • Ascites

    TESTS TO BE ORDERED

    Blood tests
    • CBP
    • Hb%
    • Hematocrit value
    • Serum alpha1-antitrypsin
    • Antinuclear antibody level
    • Serum levels of proteins S and C
    • Antithrombin III
    • Factor V Leyden
    • Anticardiolipin antibodies
    • Homocysteine
    Urinalysis
    o Macroscopic
     Urine Bilirubin
     Urine Blood
     Urine Casts
     Urine Color
     Urine Glucose
     Urine Ketones
     Urine pH
     Urine Protein
     Specific Gravity
     Urine Urobilinogen
    o Microscopic
     Urine WBS/hpf
     Urine RBC/hpf
     Urine Casts
     Urine Other

    Chest radiography
    ECG
    Echocardiography
    Pulmonary function tests
    Chest CT scan
    Right heart catheterization
    Arterial blood gas tests
    Brain natriuretic peptide (BNP)
    Doppler echocardiography
    Ventilation/perfusion (V/Q) lung scan
    Pulmonary angiography
    Ultrafast, ECG-gated CT scan
    MRI
    Radionuclide ventriculography
    Lung biopsy

    ASSESSMENT/PLAN & INSTRUCTIONS/EDUCATION

    Oxygen therapy

    Surgical Care:
    • Phlebotomy
    • Uvulopalatopharyngoplasty
    • Single-lung transplantation
    • double-lung transplantation
    • heart-lung transplantation

    MEDICATION

    • Amlodipine
    • Azelnidipine
    • Barnidipine
    • Benidipine
    • Cilnidipine
    • Efonidipine
    • Felodipine
    • Lacidipine
    • Lercanidipine
    • Manidipine
    • Nicardipine
    • Nifedipine
    • Nilvadipine
    • Nimodipine
    • Nisoldipine
    • Nitrendipine
    • Pranidipine
    • Verapamil
    • Gallopamil
    • Diltiazem
    • Acetyldigitoxin
    • Acetyldigoxin
    • Bufanolide
    • Cardenolide
    • Daigremontianin
    • Digoxin
    • Lanatoside C
    • Medigoxin
    • Ouabain
    • Peruvoside
    • Proscillaridin
    • Acenocoumarol
    • Acid-citrate-dextrose
    • Ancrod
    • Anisindione
    • Apixaban
    • Ardeparin
    • Argatroban
    • Bivalirudin
    • Brodifacoum
    • Certoparin
    • Coumatetralyl
    • Dabigatran
    • Dalteparin
    • Danaparoid
    • Defibrotide
    • Dicoumarol
    • Draculin
    • Enoxaparin
    • Fondaparinux
    • Hementin
    • Heparin
    • Hirudin
    • Lonomia
    • Otamixaban
    • Phenindione
    • Phenprocoumon
    • Pindone
    • Policosanol
    • Pulvinone
    • Rivaroxaban
    • Warfarin
    • Ximelagatran
    • Ambrisentan
    • Bosentan
    • Sitaxsentan
    • Theophylline
    • Methylxanthine
    • Furosemide

    FOLLOW UP

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