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chronic pulmonary heart disease

ICD-10 Codes

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Description

Chronic Pulmonary Heart Disease: An Overview

Chronic pulmonary heart disease, also known as cor pulmonale, is a condition that affects the right side of the heart due to long-term high blood pressure in the lungs and right ventricle. This can lead to the enlargement and failure of the right ventricle, making it harder for the heart to pump blood to the lungs.

Causes and Risk Factors

  • Chronic obstructive pulmonary disease (COPD) is the most common cause of chronic cor pulmonale [12][13].
  • Other conditions that can lead to chronic pulmonary heart disease include:
    • Pulmonary hypertension
    • Chronic blood clots in the lungs
    • Lung or heart-lung transplant complications
  • Long-term high blood pressure in the arteries of the lung and right ventricle can also contribute to this condition [1].

Symptoms

  • Shortness of breath, especially when lying down or exerting oneself
  • Swelling in the legs, ankles, and feet due to fluid buildup
  • Fatigue and weakness
  • Coughing that produces large amounts of mucus

Complications

  • Right ventricular hypertrophy (RVH)
  • Right ventricular failure
  • Heart attack
  • Lung cancer

Treatment and Management

  • Treatment for chronic pulmonary heart disease focuses on managing the underlying condition, such as COPD or pulmonary hypertension.
  • Medications to reduce fluid buildup and improve breathing may be prescribed.
  • Lifestyle changes, such as quitting smoking and exercising regularly, can also help manage symptoms.

References: [1] Definition of cor pulmonale [2] Pulmonary heart disease definition [4] Right ventricular hypertrophy (RVH) [12] Chronic obstructive pulmonary disease (COPD) as a cause of chronic cor pulmonale [13] Symptoms and complications of COPD

Additional Characteristics

  • Right ventricular failure
  • Lung cancer
  • Cor pulmonale
  • Chronic pulmonary heart disease
  • Right ventricular hypertrophy
  • Heart attack

Signs and Symptoms

Chronic pulmonary heart disease, also known as cor pulmonale, is a condition where the right ventricle of the heart becomes enlarged and fails due to increased pressure from the lungs. The symptoms/signs of this condition can be quite distressing and may include:

  • Shortness of breath: This is often one of the earliest symptoms, occurring even during routine activities [6].
  • Chest pain: Pain in the chest area, which can be a result of the heart working harder to pump blood through the damaged lungs [5].
  • Swelling of the feet or ankles: Fluid accumulation under the skin due to the heart's inability to efficiently pump blood [10].
  • Lightheadedness or dizziness: Fainting spells during activity, which can be a result of decreased blood flow to the brain [7].
  • Decreased appetite: A decrease in hunger and interest in food, possibly due to the body's increased energy expenditure on trying to compensate for the heart's inefficiency.
  • Dry cough, wheezing or hoarseness: These symptoms may occur if the lungs are damaged, leading to chronic obstructive pulmonary disease (COPD) [13].
  • Elevated heart rate or palpitations: The heart beats faster than normal due to its increased workload [9].

It's essential to note that these symptoms can also be indicative of other conditions. Therefore, a proper diagnosis by a healthcare professional is necessary for an accurate assessment and treatment plan.

References: [5] - May 1, 2024 [6] - June 28, 2023 [7] - July 28, 2023 [9] - May 15, 2024 [10] - Result: shortness of breath | chest pain | accumulation of fluid under the skin [13] - May 1, 2024

Additional Symptoms

  • Shortness of breath
  • Swelling of the feet or ankles
  • Lightheadedness or dizziness
  • Dry cough, wheezing or hoarseness
  • Elevated heart rate or palpitations
  • chest pain
  • decreased appetite

Diagnostic Tests

Diagnostic Tests for Chronic Pulmonary Heart Disease

Chronic pulmonary heart disease, also known as cor pulmonale, is a condition where the right side of the heart fails due to long-term high blood pressure in the arteries of the lung and right ventricle. The following diagnostic tests may be used to diagnose chronic pulmonary heart disease:

  • Right Heart Catheterization: This test involves inserting a thin, flexible tube called a catheter into a blood vessel, usually in the neck, and guiding it into the lower right heart chamber and the pulmonary artery. It is considered the gold standard for diagnosing cor pulmonale and assessing the severity of pulmonary hypertension.
  • Echocardiogram: A Doppler echo uses sound waves to show how the right ventricle is working and measures blood flow through the heart valves. It can help diagnose conditions such as chronic obstructive pulmonary disease (COPD) that may lead to cor pulmonale.
  • Blood Tests: While not used to directly diagnose COPD, blood tests may be used to find the cause of symptoms or rule out other conditions.
  • Pulmonary Function Tests (PFTs): These tests can help assess the severity of lung disease and exercise capacity in patients with chronic pulmonary heart disease.
  • 6-Minute Walk Test: This test measures how far a patient can walk on a flat surface in six minutes, which can indicate the severity of lung disease and exercise capacity.

Other Tests

In addition to these tests, other diagnostic tools may be used to rule out other conditions that may cause similar symptoms. These include:

  • Chest X-ray: To check for symptoms such as an enlarged heart or scarring in the lungs.
  • Electrocardiogram (ECG): To measure the electrical activity of the heart and detect any abnormalities.

References

[4] Ventilation-perfusion (V/Q) Scan: Measures how well air and blood flow into your lungs. [5] a chest X-ray – to check for symptoms such as an enlarged heart or scarring in your lungs, which can cause shortness of breath; lung function tests – to assess ... [6] Oct 4, 2024 — Lung function tests can help your healthcare provider see how well your lungs are working. They may help diagnose certain lung conditions or diseases. [7] Doppler echocardiogram: A Doppler echo uses sound waves to show how your right ventricle is working. It also measures blood flow through your heart valves. It ... [9] Dec 21, 2021 — Tests doctors may use to diagnose pulmonary hypertension include blood tests, cardiac catheterization, and pulmonary function tests. [10] Additional testing, including right heart catheterization, depends on the differential and the treatment response. [11] Cor pulmonale makes up an estimated 6% to 7% of heart disease cases in the United States. Symptoms and Causes. ... Chronic obstructive pulmonary disease (COPD). This is the top cause of long-term cor pulmonale. Pulmonary embolism ... Tests to diagnose cor pulmonale may include: Echocardiogram. Chest X-ray. Electrocardiogram ... [12] Chronic obstructive pulmonary disease (COPD) is the most common cause of cor pulmonale. ... PFTs and 6-minute walk test for assessment of the severity of lung disease and exercise capacity respectively. A right heart cath is a gold standard for diagnosis, assessment of Pulmonary hypertension severity. Right heart catheterization reveals ... [13] The likeliest causes of dyspnea are disease states involving the cardiac or pulmonary systems such as asthma, chronic obstructive pulmonary disease, heart failure, pneumonia, and coronary artery ...

Additional Diagnostic Tests

  • Blood Tests
  • Pulmonary Function Tests (PFTs)
  • Electrocardiogram (ECG)
  • Chest X-ray
  • Echocardiogram
  • Cardiac Catheterization
  • Right Heart Catheterization
  • 6-Minute Walk Test
  • Q) Scan
  • Doppler Echocardiogram

Treatment

Treatment Options for Chronic Pulmonary Heart Disease

Chronic pulmonary heart disease, also known as pulmonary hypertension, requires a comprehensive treatment approach to manage symptoms and slow disease progression. The primary goal is to reduce the strain on the heart by improving blood flow through the lungs.

  • Medications: A variety of medications can be used to treat chronic pulmonary heart disease, including:
    • Anticoagulants (e.g., warfarin): To prevent blood clots in people whose condition is associated with a high risk of clotting [4].
    • Diuretics (e.g., furosemide): To reduce excess fluid buildup in the body, making it easier for the heart and lungs to work more efficiently [5].
    • Calcium channel blockers (e.g., amlodipine): To relax blood vessels and improve blood flow through the lungs [8].
    • Beta-blockers (e.g., carvedilol): Important in patients with heart failure, as their use is associated with significantly improved morbidity and mortality [6].
  • Combination therapy: Some medications are used in combination to achieve better results. For example, macitentan and tadalafil combination therapy (Opsynvi) can decrease blood pressure in lung arteries [7].
  • Oxygen therapy: To reduce the heart's workload and help breathe easier by increasing oxygen levels in the body [9].

Important Considerations

When treating chronic pulmonary heart disease, it is essential to:

  • Make a list of important personal information, including any family history of pulmonary hypertension, lung disease, heart disease, stroke, etc. [1]
  • Follow your doctor's prescribed medication regimen exactly as directed.
  • Monitor heart and lung function through regular exercise tests, imaging studies (e.g., chest X-ray), and lab tests.

References

[1] ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension (2022) [4] Medicine. Medicines to treat pulmonary hypertension may include: Anticoagulation or blood thinners (2022) [5] Apr 18, 2023 — Medicines that keep excess fluid out of the body, called diuretics, can make the heart and lungs work better and ease the symptoms of PAH. [6] by H Olschewski · 2019 · Cited by 16 — In patients with heart failure, beta-blockers are very important drugs because their use is associated with significantly improved morbidity and mortality. [7] Aug 27, 2024 — Macitentan and tadalafil combination therapy (Opsynvi): Both medications in this single-dose tablet decrease blood pressure in lung arteries [8] Jul 29, 2024 — Calcium channel blockers can relax blood vessels and improve blood flow through the lungs. [9] An exercise test on a treadmill or stationary bike may be used to monitor heart and lung function during activity.

Recommended Medications

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Differential Diagnosis

Chronic Pulmonary Heart Disease Differential Diagnosis

Chronic pulmonary heart disease, also known as cor pulmonale, is a condition where the right ventricle of the heart becomes altered in structure and function due to a primary disorder of the lungs. The differential diagnosis for this condition involves considering various causes that can lead to similar symptoms.

Possible Causes:

  • Chronic Obstructive Pulmonary Disease (COPD): COPD is a common cause of cor pulmonale, as it leads to chronic inflammation and airflow limitation in the lungs, putting strain on the right ventricle. [1][2]
  • Pulmonary Embolism: A blood clot in the lungs can also lead to cor pulmonale by causing obstruction in the pulmonary arteries and increasing pressure on the right ventricle. [3][4]
  • Primary Pulmonary Hypertension: This is a rare condition where high blood pressure in the lungs leads to strain on the right ventricle, potentially resulting in cor pulmonale. [5][6]

Other Considerations:

  • Congestive Heart Failure: While not directly related to pulmonary heart disease, congestive heart failure can also lead to symptoms similar to cor pulmonale.
  • Right Heart Failure: This condition involves the failure of the right ventricle and can be a complication of various conditions, including COPD.

References:

[1] by DM Garrison · 2023 · Cited by 12 — Differential Diagnosis · Atrial myxoma · Blood disorders that are associated with increased blood viscosity · Chronic thromboembolic pulmonary hypertension. [2] by BR Celli · 2023 · Cited by 40 — Patients with COPD are usually older and frequently have concomitant chronic diseases, including heart failure, coronary artery disease, arrhythmias, ... [3] What causes cor pulmonale? · Chronic obstructive pulmonary disease (COPD). · Pulmonary embolism (blood clot). · Trauma or surgery that removes lung tissue. [4] Mar 14, 2023 — Cor pulmonale is defined as an alteration in the structure and function of the right ventricle (RV) of the heart caused by a primary disorder of the ... [5] Differential diagnosis · Primary pulmonary hypertension (can be considered a cause of cor pulmonale). · Pulmonary valve stenosis. · Congestive cardiac failure due ... [6] 9. Differential diagnosis · Primary pulmonary hypertension. · Pulmonary valve stenosis. · Congestive cardiac failure due ...

Additional Information

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