Pulmonary heart disease or Cor pulmonale is the enlargement and failure of the right ventricle of the heart due to increased vascular resistance or pulmonary hypertension. Pulmonary heart disease causes the right ventricle to enlarge and pump blood less effectively than normal, due to which the ventricle is then pushed to its limit and ultimately fails.
Pulmonary heart disease is a complication of lung conditions like chronic obstructive pulmonary disease (COPD) and pulmonary embolism (PE).
What are the signs and symptoms of pulmonary heart disease?
The early symptoms may go unnoticed, as they are quite similar to the feeling we get after hard work such as shortness of breath, tiredness, an increased heart rate etc. Over the time, these symptoms get worse. Visit your doctor immediately, if you have:
- Swelling in the legs or feet
- Shortness of breath
- Wheezing and coughing
- Excessive fatigue
- Enlarged neck veins
- Chest pain
- Abdominal swelling
- Cyanosis (bluish or purplish colour on the skin, lips or gums)
Pulmonary heart disease can be chronic or acute. It is usually caused by a lung disease. Chronic obstructive pulmonary disease (COPD) is the most common cause for pulmonary heart disease, however there are other factors also. The condition becomes more severe if you have a pre-existing heart disease like arrhythmia (irregular heartbeat) or a history of heart attack.
How does pulmonary heart disease arise?
Pulmonary heart disease is the adaptive response of your heart’s right ventricle to the increased afterload caused by the pulmonary hypertension. Pulmonary hypertension is caused due to increased pressure in the lungs’ arteries and your heart’s right ventricle that carries oxygenated blood to the heart while returning oxygen-depleted blood back to the lungs. An untreated pulmonary hypertension is the most common cause of pulmonary heart disease. Other conditions that can cause pulmonary heart disease include:
- Cystic fibrosis, inherited disorder that damages your lungs and digestive tract
- Sleep apnea, a sleep disorder that occurs when breathing is interrupted
- Blood clot in the lungs (pulmonary embolism)
- Lung tissue damage
- Acute respiratory distress syndrome (ARDS), where luid builds up in the air sac of lungs
- Interstitial lung disease (ILD), scarring of lungs
- Lung cancer
How pulmonary heart disease is diagnosed?
Apart from clinical examination, whereby your doctor will look for abnormal heart rhythms, fluid retention, and protruding neck veins, you will be undergoing following investigations:
- Blood tests to detect antibody levels and brain natriuretic peptide.
- Arterial blood gases (ABGs), for measuring oxygen and carbon dioxide level in blood.
- Chest X-ray or CT Scan.
- Echocardiogram which uses sound waves to produce heart images.
- Pulmonary function tests, to check how well your lungs are functioning.
- Right heart catheterization, to check pumping of your heart. It also measures the blood pressure in your heart and the main blood vessels in your lungs.
- In rare cases, lung biopsy may also be performed.
How pulmonary heart disease is treated?
Treatment for pulmonary heart disease is mainly focused with treating the underlying causes of pulmonary diseases.
- Diuretics: To reduce excess fluid collection in parts of your body.
- Heart medicine: To strengthen and regulate your heartbeat.
- Vasodilators: To improve blood flow by dilating the blood vessels.
- Antibiotics: To treat any lung infections.
- Blood thinners: To prevent blood clots.
- Bronchodilators: To relax the airways in the lungs and helps you breathe better.
- Oxygen therapy is given to reduce the pressure in the lungs.
- Heart or Lung transplant may be needed in case of advanced disease.
Pulmonary heart disease or cor pulmonale is a serious heart condition that develops due to advanced lung disease. Strategies for prevention of some of the conditions causing pulmonary heart disease would be leading a healthy lifestyle by not smoking, exercising regularly, avoiding exposure to airborne pollution. A careful management of your lung disease is also important because pulmonary heart disease stems from lung issues. It is important to monitor for any lung complications and pay close attention to any worsening signs and symptoms. Pulmonary heart disease is a progressive disease that can rapidly worsen. If left untreated, it can be life-threatening.