Etiology and clinical profile in chronic cor pulmonale
Keywords:Breathlessness, Chronic cor pulmonale, Clinical profile, Etiology
Background: Cor pulmonale is a synonym for pulmonary heart disease. The term “cor pulmonale” if broken into its constituents “cor” (heart) and “pulmo” (lungs), means cardiac involvement due to pulmonary diseases. Chronic cor pulmonale is not a single disease entity but resulting secondary to many bronchopulmonary vascular diseases and also from thoracic cage abnormalities. Cor pulmonale accounts for 5-10% of all heart diseases, 20-30% of all admissions for heart failure and 9.2% in the cardiac autopsies.
Methods: This was a hospital-based study carried among patients diagnosed with chronic cor pulmonale admitted to the medical wards of Karnataka institute of medical sciences, Hubli. during December 2011- November 2012 using simple random sampling method.
Results: The following observations were made in 50 representative cases the age group of patients was between 24 to 85 years. Chronic cor pulmonale was commonly seen in middle and elderly age groups. Incidence below 35 years is very less. Almost every patient of chronic cor pulmonale presented with breathlessness and cough. All patients in the study had Tachypnoea, Diminished chest movements, Prominent use of accessory muscles of respiration, Cyanosis, Clubbing (in some patients), Crepitations and rhonchi on chest auscultation, Loud P2 and pansystolic murmur in Tricuspid area on cardiac auscultation.
Conclusions: The peak incidence of chronic cor pulmonale was found to be in the middle and older age groups with high incidence during winter season. Smoking and dusty environment at the site of occupation were aggravating the primary lung disease. Breathlessness, cough and edema of the feet were the most common symptoms.
Gandhi MJ. Cor pulmonale and pulmonary hypertension. In: Shah SN, editor. API Textbook of Medicine. 7th ed. Mumbai: The Association of Physicians of India; 2003:487-490.
Bhargava RK. Corpulmonale (Pulmonary Heart Disease). New York USA: Futura publishing company; 1973.
Kinnula VL. Focus on antioxidant enzymes and antioxidant strategies in smoking related airway diseases. Thorax. 2005 Aug 1;60(8):693-700.
Jindal SK, Aggarwal AN, Chaudhry K, Chhabra SK, D Souza GA, Gupta D, et al. A multicentric study on epidemiology of chronic obstructive pulmonary disease and its relationship with tobacco smoking and environmental tobacco smoke exposure. Ind J Chest Dis Allied Sci. 2006;48(1):23.
Sharma SK. Chronic obstructive lung disease. In: Shah SN, editor. API Textbook of Medicine. 7th ed. Mumbai: Assoc Phys Ind; 2003:296-301.
Newman JH. Chronic Cor pulmonale. In: Fuster V, Alexander RW, O Rourke RA, Roberts R, King SR, Wellen HJJ, eds. Hurst’s the Heart. 10th ed. USA: 2001;2:1645-1654.
Shankar PS, Basavaraj UM. Incidence of cor pulmonale in Mysore State. Ind J Chest Dis. 1965;7(4):170.
Vishwanathan K. Chronic Cor pulmonale. Ind J Chest Dis. 1965; 7(4):155-69.
Banerjea JC. Natural history and symptomatology of chronic cor pulmonale. Ind J Chest Dis. 1965;7(4):174-81.
Padmavathi S, Joshi B. Incidence and etiology of chronic cor pulmonale. Dis Chest. 1984;48(4):457-63.