Cor Pulmonale

WHAT YOU SHOULD KNOW:

• Cor pulmonale is a pulmonary (lung) heart disease. It is a condition that occurs when the right ventricle of your heart cannot pump properly. Your right ventricle is the part of your heart that pumps blood to your lungs. Your heart has four chambers (spaces) including two upper atria, and two lower ventricles. When you have cor pulmonale, your right ventricle must work harder to pump blood to your lungs. Working harder causes the walls in the right ventricle to thicken and widen. Cor pulmonale weakens your heart and leads to breathing problems. Fluid may begin to build up in your body and cause swelling in your ankles, legs, and abdomen (stomach).
  
  
• Cor pulmonale can be an acute (sudden onset) or chronic (long-term) condition. Cor pulmonale can be life-threatening if the right side of your heart fails. You may need a cardiac catheterization, MRI, echocardiography, or other tests to diagnose cor pulmonale. Treatment includes oxygen, medicines, or surgery. Treatment may help your heart pump better and improve your symptoms, such as breathing problems and weakness. Treatment may reverse your cor pulmonale or prevent it from getting worse. Treatment may save your life.

AFTER YOU LEAVE:

Medicines:

• Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
  
  
• Take your medicine as directed: 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 talk with your caregiver. Medicine to improve the function of your heart may need to be given through a central line. A central line is a special IV catheter or tube that is put into a large vein (blood vessel). A central line can stay in longer than a regular IV can. A small pump will be attached to the IV that gives you a constant dose of medicine.
  
  
• Heart medicine: This medicine is given to strengthen or regulate your heartbeat. It also may help your heart in other ways. Talk with your caregiver to find out what your heart medicine is and why you are taking it.
  
  
• Vasodilators: Vasodilators may improve blood flow by making the blood vessels in your heart and lungs wider. This may decrease the pressure in your blood vessels and improve your symptoms.
  
  
• Blood thinners: This medicine helps prevent clots from forming in the blood. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. Use an electric razor and soft toothbrush to help prevent bleeding.
  
  
• Diuretics: This medicine is given to decrease edema (excess fluid) that collects in a part of your body, such as your legs. Diuretics can also remove excess fluid from around your heart or lungs and decrease your blood pressure. It is often called water pills. You may urinate more often when you take this medicine.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Avoid alcohol:

You will need to avoid drinking alcohol. Alcohol is found in beer, wine, whiskey, and other adult drinks. Drinking too much alcohol can damage your brain, heart, and liver. Drinking too much alcohol can make it harder for you to breathe and worsen your cor pulmonale. Talk with your caregiver if you drink alcohol and need help to stop.

Breathing assist:

The following may help you breathe better and decrease your symptoms of cor pulmonale:

• Do not smoke: If you smoke, it is never too late to quit. Smoking harms your body in many ways. You are more likely to have heart disease, lung disease, cancer, and other health problems if you smoke. Quitting smoking will improve your health and the health of those around you. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.
  
  
• Oxygen: You may need extra oxygen to help you breathe easier. It may be given through a plastic mask over your mouth and nose. It may be given through a nasal cannula, or prongs, instead of a mask. A nasal cannula is a pair of short, thin tubes that rest just inside your nose. Tell your caregiver if your nose gets dry or if you get redness or sores on your skin. Never smoke or let anyone else smoke in the same room while your oxygen is on. Doing so may cause a fire.
  
  
• Continuous positive airway pressure (CPAP): A CPAP machine is used to keep your airway open during sleep. With CPAP you wear a mask over your nose and mouth, or just your nose. The mask is held in place by soft elastic straps that go around your head. The mask is hooked up to the CPAP machine. The machine blows a gentle stream of air into the mask when you breathe. The stream of air helps to keep your airway open so you can breathe more regularly. Extra oxygen may be given to you through the machine also.
  
  
• Pulmonary rehabilitation: Pulmonary rehabilitation (rehab) may help improve your symptoms and prevent your cor pulmonale from getting worse. During pulmonary rehab you may learn breathing exercises to increase the oxygen levels in your body. You may also learn exercises to improve the function of your heart. Ask your caregiver for more information about pulmonary rehab.
  
  
• Pursed-lip breathing: Pursed-lip breathing can be used any time you feel short of breath. Pursed-lip breathing can be especially helpful before you start an activity.
  
  
  • __ 1. Inhale (breathe in) through your nose. Be sure you are using the muscles in your abdomen to help fill your lungs with air.
    
    
  • __ 2. Slowly exhale (breathe out) through your mouth with your lips pursed (slightly puckered). An example of pursed lips is when you pucker your lips to blow out a candle. You should make a quiet hissing sound as you breathe out through your pursed lips.
    
    
  • __ 3. Try to take as long as you can to breathe out. It should take you twice as long to breathe out as it did to breathe in. This helps you get rid of as much "used" air from your lungs as possible.
    
    
  • __ 4. Repeat this exercise several times. Once you are used to doing pursed-lip breathing, you can do it any time you need more air.

Eat a healthy diet:

You may need to change the way you eat to control your symptoms. Foods low in salt are best. You should eat a variety of healthy foods from each food group 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.

Get vaccinated:

Vaccinations are medicines to help prevent illness and disease. Your caregiver may want you to get the flu and pneumonia (lung infection) vaccine each year. Ask your caregiver about other vaccinations that you may need.

Know how your medicine pump works:

If you use a medicine pump, know how to use it, and what the alarms mean. Make sure you carry extra supplies with you and keep the medicine cool as directed. If your pump shows an error, call your caregiver right away.

Limit your liquids as directed by your caregiver:

Follow your caregiver’s advice about how much liquid you should drink each day. Drinking too much liquid can increase your risk for fluid build-up and swelling.

Maintain a healthy weight:

Maintain a healthy weight so your heart does not have to work so hard. If you are overweight, ask your caregiver about a healthy weight-loss plan.

Prevent pregnancy:

If you are a woman with cor pulmonale, pregnancy may cause health problems for you and your unborn baby. During pregnancy and childbirth, your heart works harder than usual. Your cor pulmonale symptoms may get worse, and you and your unborn baby may die. Talk with your caregiver about safe ways to prevent pregnancy. Tell your caregiver if you think or know you are pregnant.

For support and more information:

Having cor pulmonale can be life-changing for you and your family. Cor pulmonale may cause you to have feelings of worry, fear, and sadness. You may not be able to do the activities that you used to do. You and those close to you may feel anxious (worried) and scared about your future. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. You can also contact the following:

• American Heart Association National Center
  7272 Greenville Avenue
  Dallas , TX 75231-4596
  Phone: 1- 800 - 242-8721
  Web Address: http://www.americanheart.org
  

• American Lung Association
  1301 Pennsylvania Ave. NW
  Washington , DC 20004
  Phone: 1- 202 - 785-3355
  Phone: 1- 800 - 548-8252
  Web Address: http://www.lungusa.org
  

CONTACT A CAREGIVER IF:

• You are more tired than usual.
  
  
• You are urinating much less than normal for you.
  
  
• You feel dizzy, light-headed, or confused.
  
  
• You have a decreased appetite for food.
  
  
• You have new or increased swelling in your stomach, legs, or feet.
  
  
• You wake from sleep gasping for air, or you are told you stop breathing briefly while asleep.

SEEK CARE IMMEDIATELY IF:

• Your medicine pump stops working.
  
  
• You cough up blood.
  
  
• You feel anxious or depressed (deep sadness) and cannot do your regular activities.
  
  
• You have chest pain that does not go away with rest.
  
  
• You have new or increased trouble breathing at rest or with activity.
  
  
• Your hands or feet suddenly become cold to the touch.
  
  
• Your heart is beating faster than normal for you.

Copyright © 2011. Thomson Reuters. 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.

Learn more about Cor Pulmonale (Discharge Care)