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Cor Pulmonale

WHAT YOU SHOULD KNOW:

Cor pulmonale is a condition that occurs when the right side of your heart cannot pump properly.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • If you have a central line, you may get an infection. You may get a blood clot in your limb. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. If you need a heart-lung transplant, your body may reject the organs. If your body rejects your new heart and lungs, you may need another transplant. Even with treatment, your cor pulmonale may get worse. This can be life-threatening.

  • Without treatment, your heart may weaken, and your symptoms may get worse. Fluid may build up in your lungs and body, making it harder for you to breathe. You may get blood clots in your lungs and heart. Your heart, liver, and kidneys may fail. This is life-threatening.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

You may need extra oxygen

if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your healthcare provider before you take off the mask or oxygen tubing.

Central line:

This is a special IV catheter or tube. It is put into a large vein (blood vessel) near your collarbone, in your neck, or in your groin. The groin is the area where your abdomen meets your upper leg. Other central lines, such as a PICC, may be put into your arm. You may need a central line to receive medicines or IV fluids that need to be given through a big vein. You may need a central line if it is hard for caregivers to insert a regular IV. Also, a central line may stay in longer than a regular IV can. Some central lines may also be used to take blood samples.

Medicines:

  • Diuretics: These are 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 will urinate more often when you take this 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 your 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: These help prevent clots from forming in the blood. Blood thinners make it more likely for you to bleed or bruise. Use an electric razor and soft toothbrush to help prevent bleeding.

Monitoring:

  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

  • Pulmonary artery catheter: This is a balloon-tipped catheter (thin tube) inserted through a vein in your neck or groin. The pulmonary artery (PA) catheter goes into the right side of your heart and continues to your pulmonary artery. The balloon is inflated to wedge the catheter in place. The PA catheter has a device in it that measures the pressure in your heart and lungs. The catheter is attached to a monitor that shows the pressure measurements. The measurements can also show caregivers how your heart responds to certain heart medicines.

Tests:

  • Blood tests: A sample of your blood is tested to check your heart and lung function. Your blood is also tested for the amount of gases in it, such as oxygen, acids, and carbon dioxide.

  • EKG: This test checks your heart rhythm and looks for problems, such as heart damage or disease.

  • Chest x-ray: Caregivers use this picture to check the size of your heart. A chest x-ray can also show fluid around your heart and lungs.

  • Echocardiogram: An echocardiogram (echo) uses sound waves to show pictures of the size and shape of your heart. An echo records how your heart moves when it is beating and how blood flows through your heart. These pictures are seen on a monitor.

  • CT scan: This test is also called a CAT scan. An x-ray uses a computer to take pictures of your heart and lungs. The pictures may show conditions that may have caused cor pulmonale. You may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell caregivers if you are allergic to iodine or shellfish. You may also be allergic to the dye.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your heart and lungs. An MRI may show the size and function of your right ventricle. You may be given dye to help the pictures show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell caregivers if you have any metal in or on your body.

  • VQ Scan: This is a ventilation (V) and perfusion (Q) test. It shows the airways and blood vessels in your lungs. It will tell your caregiver how well your lungs are working. Radioactive dye is put into your vein to show how blood flows in your lungs. You will then breathe in a special gas. Pictures are taken to see how well your lungs breathe in oxygen.

  • Pulmonary function tests: Pulmonary function tests (PFTs) help caregivers learn how well your body uses oxygen. You breathe into a mouthpiece connected to a machine. The machine measures how much air you breathe in and out over a certain amount of time. PFTs help your caregivers decide the best treatment for you.

  • Cardiac catheterization: This is a test to see how well your heart is working. Your arteries may also be checked to see if they are blocked. A tube is threaded into your heart through a blood vessel in your leg or arm. Dye may be given so x-ray pictures of your arteries show up better on a TV-like screen. Tell caregivers if you are allergic to iodine or shellfish. You may also be allergic to the dye.

Treatment:

  • IV fluids: If your blood pressure is low or you are dehydrated, you may need IV fluids. Fluids may help increase your blood pressure and help your heart pump better.

  • Breathing support: You may need oxygen along with other devices, such as continuous positive airway pressure (CPAP), to help you breathe easier.

  • Surgery:

    • Atrial septostomy: A catheter with a balloon on one end is moved into your atria. The balloon is inflated to make an opening between your right and left atria for blood to flow through. The blood is full of oxygen for your left ventricle to pump to your body.

    • Heart and lung transplant: You may need to have a heart and lung transplant if other treatments have not worked.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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 (Inpatient Care)

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