Cor Pulmonale

WHAT YOU SHOULD KNOW:

• Cor pulmonale (KOR pull-muh-NALL-e) is when the right side of your heart begins to fail. It is also called right heart failure or pulmonary (PULL-mun-air-e) heart disease. Heart failure means that the pumping power of the heart is weaker than normal. Cor pulmonale is caused by high blood pressure in the lungs.
  
  
• The heart has 4 chambers or rooms. The 2 upper chambers are called the atria (A-tree-uh). The 2 lower chambers are called the ventricles (VEN-trih-kulls). Blood vessels bring blood from your body to the right atrium (A-tree-um) in your heart. The blood moves into the right ventricle where it is pumped into the lungs to get oxygen. The oxygen-rich blood goes into the left atrium and down into the left ventricle. The left ventricle pumps the blood into the aorta and then out to your body where the oxygen can be used.

AFTER YOU LEAVE:

Medicines:

• Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

• Aspirin to stop blood clots: Aspirin helps thin the blood to keep blood clots from forming. If caregivers tell you to take aspirin, do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than caregivers say to take.
  
  
• You may be given heart medicine to make your heart beat better or more regularly. There are many different kinds of heart medicines. Talk with your caregiver to find out what your medicine is and why you are taking it.
  
  
• You may be given diuretics (di-u-REH-tiks), which are often called "water pills." Diuretics help get rid of extra fluid in your body or lungs This can help you breathe more easily. Diuretics make you urinate more often.
  
  
• Blood thinners: Blood thinners are medicines that help prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Blood thinners may cause you to bleed or bruise more easily. Do the following if you are taking a blood thinner:
  
  
  • Watch for bleeding from your gums or nose, or in your urine or BMs.
    
    
  • Use a soft washcloth on your skin and a soft toothbrush to brush your teeth. Doing this can keep your skin and gums from bleeding.
    
    
  • Tell your dentist before dental cleanings, and other caregivers before other procedures, that you take blood thinning medicine.
    
    
  • If you shave, use an electric shaver.
    
    
  • Do not play contact sports since you may bleed or bruise easily.
    
    
  • Wear a MedicAlert bracelet or necklace that says you are taking a blood thinner medicine. You may get one from your local drugstore or contact the MedicAlert Foundation.
  
  
• How do I use my inhaler correctly?
  
  
  • Using your inhaler:
    
    
    • Remove the cover from your inhaler. If you are using a spacer, connect your inhaler to the flat end of the spacer. A spacer is a piece of plastic-like tubing that attaches to the inhaler.
      
      
    • Shake the inhaler 10 to 15 times to mix the medicine well.
      
      
    • Breathe in, then breathe out slowly all the way to empty your lungs.
      
      
    • Put the mouthpiece in your mouth past your front teeth and rest it on the top of your tongue. If you cannot put it in your mouth, hold the inhaler about 2 inches away from your mouth.
      
      
    • Breathe in very slowly with your mouth only. Breathe in while pushing down or squeezing the inhaler at the same time to create mist.
      
      
    • When your lungs are full, hold your breath for 10 seconds.
      
      
    • Breathe out slowly through puckered lips or through your nose.
      
      
    • If you need to take more puffs, wait at least one minute between each puff.
      
      
    • Rinse your mouth with water after using the inhaler. This decreases the amount of medicine left in your mouth. Rinsing also decreases the burning feeling in your throat and mouth. It may also keep you from getting a mouth infection.
    
    
  • Cleaning your inhaler:
    
    
    • Rinse the plastic sleeve of your inhaler with warm water or a mixture of 1/4 cup vinegar and 3/4 cup water. Air dry the sleeve after it has been rinsed well. Do not wash the metal part of the inhaler, since water could damage (ruin) this piece.
      
      
    • Clean your inhaler at least once per week. This will keep it from clogging up or getting germs.

Medical Appointments:

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Activity: Be as active as possible but do not get too tired. You may need to decrease physical activity until you are feeling stronger. Rest when you feel you need to. Talk to your caregiver about an activity plan that is best for you.

Breathing exercises: You may feel short of breath when you are active. The following are breathing exercises that may help you breathe more easily:

• Breathe out with pursed or puckered lips (like playing the trumpet).
  
  
• Breathe using your diaphragm. Put one hand on your abdomen and breathe in, causing your hand to move outward or upward. Your lungs will have more room to get bigger and to take in more air.

What can I do to help my breathing problems? Stay inside during very cold or hot weather. You should also stay inside on days when air pollution or pollen counts are high. If you work where the air quality is bad you may need to change your work area.

Diet:

• Eat a variety of healthy foods every day. Your diet should include fruits, vegetables, breads, dairy products, and protein (such as chicken, fish, and beans). Eating healthy foods may help you feel better and have more energy.
  
  
• Ask your caregiver if you should be on a special diet. You may be told to eat foods that are low in fat or cholesterol. You may also be told to limit the amount of salt you eat. Special cookbooks can make it easier to plan low fat and low salt meals.
  
  
• Weighing too much can make your heart work harder and can cause serious health problems. Talk to your caregiver about a weight loss plan if you are overweight.

Drinking liquids: Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Good choices for most people to drink include water, juice, and milk. If you are used to drinking liquids that contain caffeine, such as coffee, these can also be counted in your daily liquid amount. Some food items such as soup and fruit also add liquid to your diet. Ask your caregiver how much liquid you should have each day.

Drinking Alcohol: If you drink alcohol, decrease the amount you drink or quit drinking completely. The heart does not beat as well if you drink alcohol. Almost every part of your body can be harmed by alcohol. Drinking alcohol can make your heart failure worse.

Smoking: If you smoke of chew tobacco, you should quit. It is never too late to quit smoking. Smoking harms the heart, lungs, and the blood. You are more likely to have a heart attack, lung disease, and cancer if you smoke. You will help yourself and those around you by not smoking. Ask your caregiver for the CareNotes™ handout on how to stop smoking if you are having trouble quitting.

Support socks: You may need to wear support socks. The support socks are also called Ted Hose® or Jobst Stockings®. These socks may help decrease the swelling in your legs until you are walking more. They may also keep blood from staying in your legs and causing clots.

Weight: Weighing more than what your caregiver suggests may make your heart work harder and cause bad health problems. You may need to talk to your caregiver about a weight loss plan.

Weight: Weigh yourself daily before breakfast. Weight gain can be a sign of extra fluid in your body. Call your caregiver if you have gained two to three pounds in a day.

Support:

• Cor pulmonale is a life-changing disease for you and your family. Accepting that you have heart disease is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand how to support a person with heart disease.
  
  
• You may also want to join a support group. This is a group of people who also have heart disease. Ask caregivers for the names and numbers of support groups in your town. You can contact the following national organizations for more information:
  • American Heart Association National Center
    7272 Greenville Avenue
    Dallas, TX 75231-4596
    Phone: 1-800-242-8721
    Web Address: http://www.americanheart.org
    
  • National Asthma Education and Prevention Program
    National Heart, Lung and Blood Institute
    National Asthma Education and Prevention Program
    P.O. Box 30105
    Bethesda, MD 20824-0105
    Phone: 1-301-592-8573
    Web Address: http://www.nhlbi.nih.gov/about/naepp/
    

CONTACT A CAREGIVER IF:

• You have a fever (increased body temperature).
  
  
• You gain 2 to 3 pounds in 1 day or 5 pounds in 1 week.
  
  
• You have increased shortness of breath.
  
  
• The swelling in your ankles increases.
  
  
• Your sputum is brown, red, or has blood in it.
  
  
• You have chills, a cough, or feel weak and achy. These are signs that you may have an infection.
  
  
• Your skin is itchy, swollen, or has a rash. Your medicine may be causing these symptoms. This may mean you are allergic (uh-ler-jik) to your medicine.
  
  
• You have questions or concerns about your illness or medicine.

SEEK CARE IMMEDIATELY IF:

• You have trouble breathing all of a sudden. This could be a sign that you have a blood clot in your lung. It could also mean that you are having heart failure or are allergic to a medicine you are taking.
  
  
• You have signs of a heart attack:
  
  
  • Chest pain or discomfort that spreads to your arms, jaw, or back.
    
    
  • Unusual, sudden back pain.
    
    
  • Nausea (sick to your stomach).
    
    
  • Trouble breathing.
    
    
  • Sweating.
    
    
  • Lips or nailbeds that turn blue or white in color.
    
    
  • This is an emergency. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive yourself!

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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