Cardiovascular system >>>> Pulmonary heart syndrome

Pulmonary heart syndrome.

An increase in blood pressure in the pulmonary circulation associated with pathological processes in the lungs causes a thickening of the myocardium and an increase in the volume of the right atrium and right ventricle. Such a change in the heart muscle is called cor pulmonale syndrome or simply “cor pulmonale”. The development of pulmonary heart syndrome can be acute, subacute, or chronic.

Acute cor pulmonale manifests itself in case of impaired vascular patency (for example, thromboembolism of the main trunk or branches of the pulmonary artery) or diseases of the bronchi and lungs (obstructive bronchitis, pneumonia). Pathological disorders are detected within a few hours.

For subacute cor pulmonale, an increase in the pathological state of the myocardium is characteristic for a certain time (weeks or months). The causes of its occurrence are considered to be microembolism of pulmonary arterioles, vasculitis of the pulmonary arteries, pulmonary hypertension, fibrotic changes in the walls of the pulmonary arteries, metastasis of the mediastinum as a result of neoplasms of the esophagus, stomach and other organs, complicated bronchial asthma.

Pathological processes in chronic pulmonary heart disease increase in the period from one year to several years. The reasons for the development of chronic pulmonary heart disease are vascular disorders (arteritis, embolism), diseases of the bronchi and lungs (obstructive bronchitis, bronchial asthma, pulmonary emphysema, partial or complete removal of one lung, fibrocystic formations in the lung tissue), infectious diseases (tuberculosis), pathological deformities and trauma of the chest, diseases of a neuromuscular nature (apnea, poliomyelitis), adhesions in the pleural cavity, obesity.

Typical signs of cor pulmonale:

an attack of sharp pain in the chest area;
increasing shortness of breath;
cyanosis (blue lips, nails, facial skin);
possible swelling of the veins of the cervical spine;
rapid heart rate (above 100 beats per minute);
tachycardia (heart palpitations);
pain in the region of the heart;
increased fatigue;
swelling of the lower extremities.

Examination of the patient reveals:

an increase in the volumetric dimensions of the heart (especially on the right),
expansion of the border of the heart to the right of the sternum,
heart murmurs,
enlarged liver.

When diagnosing a disease, a history of bronchopulmonary diseases must be taken into account.

Treatment of cor pulmonale depends on the severity and speed of the process. In acute pulmonary heart disease, resuscitation measures are taken to combat pain syndrome, restore vascular patency; carry out inhalation with oxygen or artificial ventilation of the lungs.

In chronic pulmonary heart disease, in addition to measures to improve or restore the blood supply to the heart and brain, drug therapy is carried out for diseases that cause the development of pulmonary heart syndrome:

For infections of the respiratory system, antimicrobial therapy is performed,
With obstructive processes in the bronchi, bronchodilators are prescribed,
To reduce pulmonary hypertension, calcium antagonists are taken, which have a vasodilating effect due to the relaxation of smooth muscles of the walls of blood vessels and bronchi,
With a tendency to thromboembolism of the pulmonary vessels, blood thinners (antiplatelet agents, fibrinolytics) are used,
To improve vascular patency, vasodilators are taken,
To improve and support the work of the heart muscle, take cardiac glycosides,
To lower blood pressure, take diuretic herbal or synthetic drugs, as well as drugs that normalize blood pressure,
They carry out regular oxygen inhalations,
Assign breathing exercises, chest massage to eliminate congestion in the bronchopulmonary structures.