00:00 / 00:00
Bundle branch block
Pulseless electrical activity
Atrioventricular nodal reentrant tachycardia (AVNRT)
Premature atrial contraction
Long QT syndrome and Torsade de pointes
Premature ventricular contraction
Rheumatic heart disease
Atrial septal defect
Coarctation of the aorta
Patent ductus arteriosus
Ventricular septal defect
Hypoplastic left heart syndrome
Tetralogy of Fallot
Total anomalous pulmonary venous return
Transposition of the great vessels
Pericarditis and pericardial effusion
Aortic valve disease
Mitral valve disease
Pulmonary valve disease
Tricuspid valve disease
Coronary steal syndrome
Polycystic kidney disease
Renal artery stenosis
Peripheral artery disease
Subclavian steal syndrome
Superior mesenteric artery syndrome
Human herpesvirus 8 (Kaposi sarcoma)
Chronic venous insufficiency
Deep vein thrombosis
Acyanotic congenital heart defects: Pathology review
Aortic dissections and aneurysms: Pathology review
Atherosclerosis and arteriosclerosis: Pathology review
Cardiac and vascular tumors: Pathology review
Cardiomyopathies: Pathology review
Coronary artery disease: Pathology review
Cyanotic congenital heart defects: Pathology review
Dyslipidemias: Pathology review
Endocarditis: Pathology review
Heart blocks: Pathology review
Heart failure: Pathology review
Hypertension: Pathology review
Pericardial disease: Pathology review
Peripheral artery disease: Pathology review
Shock: Pathology review
Supraventricular arrhythmias: Pathology review
Valvular heart disease: Pathology review
Vasculitis: Pathology review
Ventricular arrhythmias: Pathology review
0 / 7 complete
0 / 1 complete
from obstructive lung disease p. 694
penumonoconioses p. 698
pulmonary hypertension p. 699
right ventricular failure p. 686
cor pulmonale p. 686
cor pulmonale p. 699
With cor pulmonale, cor is Latin for heart and pulmonale is Latin for lungs.
Cor pulmonale, then, is a relationship between the two, it’s when a disorder of the lungs causes dysfunction of the heart.
Normally, de-oxygenated venous blood from the body goes into the right atrium of the heart.
From there, it goes into the right ventricle and gets pumped into the lungs where it is reoxygenated as it goes through the pulmonary circulation.
The pulmonary circulation is a low-resistance system with pressures ranging between 10 mmHg and 14 mmHg.
After going through the lungs, oxygenated blood goes into the left atrium, and then into the left ventricle, and finally gets pumped back out to the body.
When the heart can’t pump enough blood to meet the body’s demands, it’s initially called heart dysfunction and can worsen to the point where it’s called heart failure.
This can happen in two ways, either it’s systolic heart failure, where the ventricles can’t pump blood hard enough during systole, or diastolic heart failure, where not enough blood fills the ventricles during diastole, called diastolic heart failure.
Heart failure can affect the right ventricle, the left ventricle, or both ventricles, so someone might have, right-sided heart failure, left-sided heart failure, or both which is called biventricular heart failure.
Cor pulmonale is when a lung disorder causes right-sided heart dysfunction that can develop into right-sided heart failure.
Lung disorders make it harder to oxygenate the blood, which can lead to hypoxia, or low oxygen levels.
In response, this triggers a process called hypoxic pulmonary vasoconstriction.
Let’s say you have a couple pulmonary arterioles here, meaning they’re in the lungs, and the alveoli of the lungs here, and oxygen exchange between the two.
If one of these alveoli is poorly ventilated, the corresponding arteriole vasoconstricts to divert blood away from it.
This works pretty well, but when lots of alveoli are poorly ventilated like with a lung disorder, they all start to vasoconstrict and the mechanism backfires.
When lots of arterioles vasoconstrict together, there’s an increase in resistance and it leads to pulmonary hypertension - with the pulmonary blood pressure rising above 25 mm Hg.
The high pulmonary pressure makes it hard for the right ventricle to pump blood into the pulmonary circulation.
As compared to the left side, the right side of the heart is thinner walled and used to ejecting against a low pulmonary vascular resistance.
In acute lung disorders, like a pulmonary embolism, where a blood clot blocks blood flow in a pulmonary artery, the result is a rapid increase in right ventricular pressure that makes the right ventricle stretch out like a water balloon.
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