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Cor Pulmonale, Emergency Medicine

Richard E. Wolfe Reviewed 06/2017
 


Basics

Description

Right ventricular hypertrophy (RVH) or dilation caused by elevated pulmonary artery pressure. RVH due to a systemic defect or congenital heart disease is not classified as cor pulmon...

Diagnosis

Signs and Symptoms

  • Exertional dyspnea

  • Easy fatigability

  • Weakness

  • Exertional syncope

  • Cough

  • Hemoptysis

  • Exertional angina even in the absence of coronary disease

  • Anorexia

  • Right upper quadrant discomfort

  • ...

Treatment

Pre-Hospital

  • Supportive therapy:

    • Supplemental oxygen

      • To an endpoint of 90% arterial saturation

    • IV access

    • Cardiac monitoring

    • Pulse oximetry

  • Treat bronchospasm from associated respiratory disease:

    • β-A...

Follow-Up

Disposition

Admission Criteria

  • New-onset hypoxia

  • Anasarca

  • Severe respiratory failure

  • Admission criteria for the underlying disease process

Discharge Criteria

Patients without hypoxia or a stable ox...

Pearls and Pitfalls

  • The physical exam is unreliable for detecting cor pulmonale in patients with COPD, as hyperinflation of the chest obscures the classic findings.

  • Vasodilator therapy should only be c...

Additional Reading

  • Benza  R, Biederman  R, Murali  S, et al. Role of cardiac magnetic resonance imaging in the management of patients with pulmonary arterial hypertension. Am Coll Cardiol.  2008;...

Codes

ICD9

  • 415.0 Acute cor pulmonale

  • 416.9 Chronic pulmonary heart disease, unspecified

ICD10

  • I26.09 Other pulmonary embolism with acute cor pulmonale

  • I27.81 Cor pulmonale (chronic)

SNOMED

  • 83291003 Cor pulmo...

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