Related articles: Pulmonary heart
Definition
The pulmonary heart (or right heart failure) is the dilation of the right ventricle in response to an increase in pulmonary arterial pressure. The condition is secondary to diseases of the chest and lungs and the pulmonary circulation. In this context, pulmonary hypertension can occur due to reduction of the capillary bed, vasoconstriction due to hypoxia and / or hypercarbia, increased alveolar pressure or due to occlusion and hypertrophy of a vessel. Pulmonary hypertension induces a work overload of the right ventricle and causes a cascade of events that compromises cardiac function.
The pulmonary heart usually has a chronic course, but can also be acute and reversible if identification and treatment are early. Chronic pulmonary heart disease is attributable to chronic lung diseases, including chronic obstructive pulmonary disease, pulmonary fibrosis, neglected bronchopneumonia, asthma and occupational diseases, such as silicosis. The acute pulmonary heart, on the other hand, is consequent to sudden pulmonary pathological events, such as haemorrhages, embolisms and pneumothorax.
Most common symptoms and signs *
- Arrhythmia
- Ascites
- Asthenia
- Swollen ankles
- Cyanosis
- Hepatic congestion
- Convulsions
- Dyspnoea
- Distension of the neck veins
- Chest pain
- Edema
- Hemoptysis
- Hepatomegaly
- Atrial flutter
- Hypercapnia
- Hypoxia
- Hypotension
- orthopnea
- Pallor
- Paradoxical pulse
- Water retention
- Heart murmur
- Drowsiness
- Confusional state
- Sweating
- Fainting
- Tachycardia
- tachypnoea
- Cough
Further indications
The pulmonary heart causes more or less severe cardiac distress.
At first, the chronic pulmonary heart is asymptomatic, although patients report symptoms due to basic lung disease, such as difficulty breathing and asthenia. Later, with the increase in pulmonary hypertension, cough with sputum mixed with blood, peripheral edema, distention of the neck veins, hepatomegaly and arrhythmias appear. In the chronic pulmonary heart, the risk of venous thromboembolism is increased.
The acute pulmonary heart, on the other hand, should be suspected in case of acute dyspnea associated with hypotension, pallor, tachycardia, turgidity of the jugular veins, cough (sometimes with blood sputum), thoracic pain, convulsions and circulatory collapse.
The diagnosis is based on clinical, radiographic and echocardiographic evaluation; for confirmation, catheterization of the right heart may be necessary.
The treatment of the pulmonary heart is directed to the disease on which it depends (chronic form) or to the removal of the cause (acute form). Chronic form therapy may include: anticoagulant therapy, oxygen therapy and respiratory rehabilitation programs. The acute pulmonary heart, on the other hand, is oriented towards the improvement or reduction of hypoxia. Subsequently, the use of thrombolytics may be indicated.
