Symptoms of pulmonary vascular cor pulmonale

summary

Pulmonary heart disease, referred to as pulmonary heart disease, is mainly caused by bronchial lung tissue or pulmonary artery vascular lesions, pulmonary hypertension caused by heart disease, according to the onset and duration of disease, can be divided into acute and chronic two categories, the latter is more common in clinic, the development of the disease is relatively slow, in addition to the original clinical symptoms and signs of pulmonary chest disease, The main signs are pulmonary heart failure and other organ damage. Pulmonary encephalopathy is a syndrome caused by respiratory failure * hypoxia, carbon dioxide retention and mental disorders. It is the primary cause of death in cor pulmonale, and it should be actively prevented and cured. Pulmonary vascular pulmonary heart disease symptoms to share my views with you.

Symptoms of pulmonary vascular cor pulmonale

1. Lung and heart function compensation stage (including remission stage) this stage is mainly the manifestation of chronic obstructive pulmonary disease (COPD). Chronic cough, expectoration, shortness of breath, palpitation, dyspnea, fatigue and decreased labor endurance. Physical examination can have obvious emphysema, auscultation breath sound weakened, occasionally dry, wet rales, lower limb edema, obvious in the afternoon, disappear in the next morning. Heart voiced boundary is often difficult to knock out due to emphysema.

2. The main clinical manifestation of decompensated lung and heart function (including acute exacerbation) is respiratory failure, with or without heart failure. The heart sound is far away, but the second heart sound may be hyperechoic in the pulmonary valve area, indicating pulmonary hypertension. Systolic murmur in tricuspid valve area or heart beat under xiphoid process, which mostly indicates right heart hypertrophy and enlargement. In some cases, due to emphysema, the intrapleural pressure increased, which hindered the return of vena cava, and the jugular vein was filled. Because of the descending diaphragm, the upper and lower border of the liver obviously moved underground.

3. Echocardiography can diagnose cor pulmonale by measuring the diameter of right ventricular outflow tract (≥ 30mm), diameter of right ventricle (≥ 20mm), thickness of right ventricular anterior wall, ratio of left and right ventricular diameter (< 2), diameter of right pulmonary artery or pulmonary artery trunk and enlargement of right atrium.

matters needing attention

(1) To control infection, antibiotics were selected according to sputum culture and drug sensitivity test. Penicillins, aminoglycosides, quinolones and cephalosporins are commonly used. In principle, narrow-spectrum antibiotics should be used as the main choice, and attention should be paid to the possible secondary fungal infection when using broad-spectrum antibiotics（ 2) * oxygen therapy to smooth the respiratory tract, correct hypoxia and carbon dioxide retention. 3) Control of heart failure patients with pulmonary heart disease in general actively control infection, improve respiratory function, heart failure can be improved. The patient's urine volume increased, the edema subsided, the swollen liver shrank and tenderness disappeared. Diuretic, cardiotonic or vasodilator can be used for the patients who have no effect after treatment（ 4) Control arrhythmia, general arrhythmia after treatment of pulmonary heart disease infection, hypoxia can disappear. If persistent, drugs can be selected according to the type of arrhythmia.