Cor Pulmonale: Causes, Symptoms, Treatment and Cost

Cor Pulmonale is a type of right heart failure caused by chronic lung disease, such as chronic obstructive pulmonary disease (COPD) and other pulmonary diseases. The main feature of Cor Pulmonale is an increase in the pressure within the right side of the heart due to an underlying lung disorder.

• Acute Cor Pulmonale: This type of cor pulmonale is caused by a sudden decrease in the amount of oxygen in the blood due to a lung disease or other medical condition. It can be life-threatening and requires immediate medical attention.
• Chronic Cor Pulmonale: This type of cor pulmonale is caused by long-term exposure to conditions that reduce the amount of oxygen available in the blood, such as chronic obstructive pulmonary disease ( COPD) or emphysema. Symptoms may include swelling of the legs, fatigue, and shortness of breath.

It is usually caused by chronic lung diseases, such as:-

• Chronic Obstructive Pulmonary Disease (Copd)
• Emphysema.

Other Causes Include:

• Sleep Apnea,
• Genetic Diseases

following are the symptoms of cor pulmonale:-

• Shortness of breath: This is the most common symptom of cor pulmonale and may be due to an increase in pulmonary arterial pressure, a decrease in cardiac output, or a combination of both.
• Fatigue: This can occur due to the decreased blood flow through the lungs, leading to decreased oxygen delivery to the muscles, resulting in fatigue after even minimal exertion.
• Swelling: Swelling of the feet and ankles is common due to fluid accumulation in these areas as a result of increased pressure in the pulmonary arteries.
• Coughing: A dry cough or one with frothy sputum can be present due to increased pulmonary artery pressure leading to increased leakage of fluid into the airways.
• Chest pain: This may occur due to inflammation of the lining around the heart (pericardium) caused by increased pressure within the pulmonary arteries pushing against it from outside.
• Palpitations: These are usually caused by arrhythmias (irregular heartbeats).
• Wheezing: Wheezing may be present as a result of airway narrowing caused by inflammation and/or fluid accumulation within them secondary to cor pulmonale

The best way to prevent Cor Pulmonale is to avoid activities and exposures that can cause or worsen lung disease. This includes:

• Quitting smoking
• Avoiding secondhand smoke
• Avoiding air pollution, such as vehicle exhaust and industrial fumes
• Treating underlying health conditions that can lead to lung damage, such as asthma and COPD
• Staying up to date on vaccinations, including the flu vaccine and pneumococcal vaccine

The diagnosis of Cor Pulmonale requires a combination of physical examination, medical history, imaging tests, and laboratory tests.

• Physical Examination: During physical examination, your doctor will check for signs and symptoms associated with Cor Pulmonale such as shortness of breath, fatigue, swelling in the feet or legs (edema), rapid breathing (tachypnea), cyanosis (blue tinting to the skin or nails due to low oxygen levels), wheezing, clubbing of fingers or toes (enlarged fingertips due to increased tissue growth) and an enlarged liver.
• Medical History: Your doctor may ask questions regarding past medical history including family history as well as any underlying conditions that may be causing your symptoms.
• Imaging Tests: Imaging tests such as chest X-rays or CT scans can help diagnose Cor Pulmonale by allowing your doctor to view the lungs and heart for any abnormalities such as inflammation or damage caused by diseases like COPD or ILD.
• Laboratory Tests: Blood tests can be performed to check for levels of oxygen in the body as well as electrolyte imbalances which may indicate fluid retention due to edema from congestive heart failure related to Cor Pulmonale . Additionally an echocardiogram can measure right ventricular pressures which are typically elevated in patients with this condition.

Cor Pulmonale, or right-sided heart failure due to pulmonary disease, can lead to a number of complications.

These include:

• Reduced oxygen levels in the blood;
• Increased risk of blood clots in the lungs;
• An increased risk of respiratory infections;
• Damage to the lungs over time; and eventually, death if not managed properly.

The following are the home remedies for cor pulmonale:

• Inhaling steam from a warm bath.
• Gargling every morning with warm salt water can be beneficial for your respiratory tract. It is an effective home remedy for relieving an irritated nose and throat.
• You name the ailment and ginger is the solution. And for respiratory problems, it is one of the most effective home remedies.

Here are some suggestions for what to eat if you have Cor Pulmonale:

• Oatmeal with low-fat milk
• Lean proteins such as fish or chicken
• Fruits such as apples, oranges and bananas
• Vegetables such as broccoli, spinach and carrots
• Whole grains such as brown rice or quinoa
• Low fat dairy products like yogurt or cottage cheese
• Beans and legumes like lentils or black beans
• Nuts like almonds or walnuts
• Healthy fats like olive oil or avocados

Food includes:

• Processed meats such as bacon, sausage, salami, and deli meats
• Fried foods
• High-sodium foods like canned soups and frozen meals
• Sugary drinks like soda and juice
• Alcoholic beverages
• Caffeinated beverages such as coffee and tea

Treatment may include:

• Medications: Doctors may prescribe medications such as diuretics, ACE inhibitors, and beta-blockers to reduce fluid buildup in the body and control blood pressure.
• Oxygen therapy: This involves using oxygen tanks or masks to increase oxygen levels in the blood for those who have difficulty breathing.
• Surgery: Procedures such as a lung transplant or tracheostomy can be used to treat severe cases of cor pulmonale.
• Pulmonary rehabilitation: This involves physical therapy and exercise programs designed to help patients manage their condition and improve their quality of life.
• Lifestyle changes: Quitting smoking, eating a healthy diet, getting regular exercise, and limiting alcohol consumption can also help improve symptoms associated with cor pulmonale.

If you have symptoms of Cor Pulmonale, you should consult a pulmonologist or respiratory specialist. They will be able to diagnose and treat this condition.

• Oxygen Therapy: Oxygen therapy is a commonly used treatment for cor pulmonale. It helps to improve oxygen levels in the blood and reduce strain on the right ventricle of the heart.
• Pulmonary Rehabilitation: Pulmonary rehabilitation programs are designed to help patients with chronic lung diseases improve their overall quality of life by providing education about their condition, exercise instruction and other resources to manage their illness more effectively over time.

The most common surgical treatments for Cor Pulmonale are:

• Lung volume reduction surgery: Lung volume reduction surgery (LVRS) is a surgical procedure used to treat cor pulmonale. During this procedure, small sections of severely damaged or diseased lung tissue are removed to reduce the volume of the affected lung and improve its functioning. The goal of LVRS is to reduce symptoms such as shortness of breath, fatigue and difficulty in performing daily activities.
• Lung transplantation: Lung transplantation involves removing a diseased or failing lung and replacing it with a healthy donor organ. This procedure may be offered to individuals with irreversible cor pulmonale who are unable to benefit from other treatments.
• Balloon pulmonary angioplasty: During BPA, a balloon-tipped catheter is inserted through a vein in the patient’s arm or groin and advanced to the affected part of the lung artery. The balloon then inflates to widen and open up blocked or narrowed passages. This procedure helps reduce pressure in the lungs, improving blood flow, oxygenation and circulation throughout the body.
• Endobronchial valves: Endobronchial valves are devices used to treat severe emphysema. They are inserted into the airways of the lungs to reduce the volume of air in diseased lung tissue. This reduces strain on the heart, allowing it to work more efficiently and alleviating symptoms of cor pulmonale.
• Pleurodesis: The procedure involves the application of an irritant substance (such as talc, tetracycline, or various sclerosing agents) to the pleural space in order to cause scarring and adhesion of the two layers of tissue (the parietal and visceral pleura).

The best medicines for Cor Pulmonale depend on the underlying cause of the condition such as:

• Bronchodilators: These drugs help to relax the muscles around the airways and open them up, allowing more air to flow into and out of the lungs. Examples include albuterol, ipratropium, and tiotropium.
• Corticosteroids: These drugs reduce inflammation in the lungs and can help reduce symptoms like shortness of breath. Examples include prednisone, fluticasone, and budesonide.
• Anticoagulants: These drugs help prevent blood clots from forming in the lungs, which can be a complication of Cor Pulmonale. Examples include warfarin (Coumadin) and heparin.
• Diuretics: These drugs help remove excess fluid from your body, which can reduce swelling in your extremities caused by Cor Pulmonale. Examples include furosemide (Lasix) or spironolactone (Aldactone).

The recovery time for Cor Pulmonale varies depending on the severity of the condition, but it can take several weeks to months for a full recovery.

The results of treatment for cor pulmonale depend on the underlying cause and the severity of the condition. In some cases, treatment may be able to reduce symptoms and improve quality of life, but it may not be permanent.

People with chronic lung diseases may need to continue to take medications or receive ongoing treatments to manage their symptoms.

• Monitor patient's oxygen levels and vital signs.
• Monitor oxygen saturation, if needed.
• Provide additional oxygen therapy as needed.
• Encourage deep breathing and coughing exercises to help clear the lungs and reduce fluid accumulation in the lungs (pulmonary edema).
• Instruct patients on proper activity level; too much physical activity may cause strain on the heart or lungs that can lead to complications post-surgery (such as pulmonary edema).

The cost of Cor Pulmonale treatments in India vary depending on the severity of the condition and the treatment chosen. Generally, the cost of medicines, doctor consultation fees, hospitalisation costs, and other medical tests can range anywhere between Rs 10,000 to Rs 2 lakhs or more.

The side effects of Cor Pulmonale treatments vary depending on the type of treatment being used. Common side effects can include:

• Fatigue
• Dizziness
• Nausea
• Headaches
• Shortness of breath
• Low blood pressure
• Swelling in the ankles, feet and legs
• Low red blood cell count (anaemia)
• Changes in heart rate or rhythm (arrhythmias)
• Abnormal liver function tests

If you are suffering from any complications relating to Cor Pulmonale then you should consult a doctor nearby as they can cause complications like ' COPD or asthma, and cardiac disorders' ' in which treatment courses can range from 5 to 6 months to 3-4 years depending on the severity of the situation.