JSC Astana Medical University Done by: Kazhimuratova M.E. Group: 413 GM Checked by:D.B Astana,2018 y.

Plan: I.Inroduction. Pulmonary heart disease II.Main body a)The main causes of them b)Clinical features c)Diagnosis and treatment III. Conclusion

Pulmonary heart disease or cor pulmonale is the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance (such as from pulmonic stenosis) or high blood pressure in the lungs.

Acute Acute pulmonary heart disease usually results in dilatation. Dilatation is a stretching (in length) of the ventricle in response to acute increased pressure Chronic Chronic pulmonary heart disease usually results in right ventricular hypertrophy (RVH) Hypertrophy is an adaptive response to a long-term increase in pressure.

Acute PHD massive thromboembolism in the pulmonary artery system; valve pneumothorax; severe prolonged attack of bronchial asthma; common acute pneumonia. Factors contributing to the development of pulmonary embolism should include Increase of coagulability atherosclerosis and vasculitis in the pulmonary artery system increase in blood pressure in the pulmonary circulation

Bronchopulmonary form, diseases affecting the airways and alveoli: chronic obstructive bronchitis, pulmonary emphysema, bronchial asthma, pneumoconiosis, bronchiectasis, polycystic lung disease, sarcoidosis, pneumosclerosis, etc. Thoracodiaphragmatic form, diseases of the thorax with limited mobility: kyphoscoliosis, ankylosing spondylitis, post-thoracoplasty, pleural fibrosis, neuromuscular diseases (poliomyelitis), diaphragm paresis, Pickwick syndrome in obesity, etc.; Vascular form; diseases affecting the pulmonary vessels: primary pulmonary hypertension, thromboembolism in the pulmonary artery system, vasculitis (allergic, obliterating, nodular, lupus, etc.), atherosclerosis of the pulmonary artery, compression of the pulmonary arteries, and pulsation of the pulmonary arteries

CyanosisAscitesWheezing Shortness of breath

Enlargement of the liver Raised jugular venous pressure Jaundice Presence of abnormal heart sounds Intercostal recession Pain in chest

Investigations available to determine the cause of cor pulmonale include the following: Chest x-ray – right ventricular hypertrophy, right atrial dilatation, prominent pulmonary artery Pulmonary hypertension Instrumental diagnostics

ECG – right ventricular hypertrophy, dysrhythmia, P pulmonale (characteristic peaked P wave) Thrombophiliascreen - to detect chronic venous thromboembolism (proteins C and S, antithrombin III, homocysteine levels) P pulmonale

Contrast-enhanced computed tomography of the chest of a patient with pulmonary arterial hypertension. Massive dilatation of the pulmonary arterial trunk and branches (#). The ratio of the diameter of aorta (Ao) to the diameter of main pulmonary artery (PA) is >1.5. Computed tomography

Macro-preparation

In the clinical analysis of blood is determined by compensatory erythrocytosis, ESR slowdown. In the biochemical analysis of blood cholesterol and β lipoproteins are often lowered. Laboratory investigation

In the analysis of urine revealed signs of stagnation in the kidneys: microhematuria, small proteinuria, hyaline cylinders. Characterized by a decrease in glomerular filtration and nocturia.

Treatment antibiotics expectorants oxygen therapy diuretics digitalis Vasodilators and anticoagulants

bronchodilator require when wheezing is present, the majority of individuals Anticoagulants used when venous thromboembolis m is present Oxygen required to resolve the shortness of breath. to the lungs also helps relax the blood vessels and eases right heart failur requires diuretics to decrease strain on the heart

euphyllinum (intravenously, orally, rectally in the early stages - nifedipine, with decompensated course - nitrates (isosorbide dinitrate, nitroglycerin) under the control of blood gas composition due to the risk of hypoxemia. For the purpose of correction arterial hypertension potassium-sparing diuretics (triamteren, spironolactone, etc.) in case of left ventricular insufficiency, cardiac glycosides (intravenous Korglikon) are used. With symptoms of circulatory insufficiency right ventricula type

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