Cor pulmonale

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Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Special risks (e.g. anesthetic), Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Sequelae, Prognosis, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Phil Fox DVM DipACVIM DipECVIM ACVECC
Dr Serena Brownlie BVM&S PhD CertSAC MRCVS
Dr Philip K Nicholls BVSc BSc PhD MRCVS FRCPath
Synonyms Pulmonary heart disease

Introduction

  • Quite rare in the cat.
  • Cause : pulmonary hypertension.
  • Signs : usually few clinical signs; in animals right-sided heart failure is rare.
  • Diagnosis : right heart enlargement (radiography, ultrasonography, ECG) and demonstration of respiratory disease.
  • Treatment : manage underlying cause and symptomatic only.
  • Prognosis : depends on severity of cardiorespiratory changes.

Diagnosis

Clinical signs

  • May be asymptomatic as regards to cor pulmonale.
  • Signs of underlying respiratory disease:
    • Wheezing.
    • Tachypnea.
    • Pulmonary crackles (emphysema).
  • Signs of right-sided heart failure  Congestive heart failure  :
    • Reduced breath sounds (pleural effusion).
    • Gallop rhythm or murmur on auscultation.
    • Jugular distension or pulse.
    • Ascites.

Diagnosis

Differential diagnosis

Other causes of right-sided congestive failure
  • Dilated cardiomyopathy  Heart: dilated cardiomyopathy (DCM)  .
  • Pericardial effusion.
  • Congenital cardiac anomalies:
    • Pulmonic stenosis.
    • Tetralogy of Fallot  Tetralogy of fallot  .
    • Tricuspid stenosis.
    • Congenital right-to-left shunts.

Sequelae

Prognosis

  • Depends very much on severity of underlying respiratory disease and response to therapy.
  • Ventricular hypertrophy may resolve once respiratory disease is controlled.
  • Prognosis must be more guarded if right-sided heart failure has developed - this may be irreversible.

Reasons for treatment failure

  • Presence of irreversible cardiac changes.
  • Underlying respiratory problem not treatable.

Sources

Publications

Refereed papers

  • Sottiaux J & Franck M (1999)Pulmonary embolism and cor pulmonale in a cat.JSAP40(2), 88-92.

Other sources of information

  • Padrid P A (1995) In:Manual of canine and feline cardiology.pp 413-422.

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