Basic knowledge of cor pulmonale

1. Introduction of some common sense about cor pulmonale

Hello, cor pulmonale is the abbreviation of pulmonary heart disease, which is pulmonary hypertension secondary to various chest and bronchial diseases and eventually leads to heart disease characterized by right ventricular hypertrophy.

Most cor pulmonale develops from chronic bronchitis and obstructive emphysema, and a few are related to bronchial asthma, tuberculosis and bronchiectasis. Pulmonary heart disease exists all the year round, more than respiratory failure and heart failure caused by respiratory tract infection in winter and spring, and the mortality rate is high.

This disease belongs to the categories of asthma syndrome, phlegm syndrome, edema and drinking syndrome in traditional Chinese medicine. And cor pulmonale is a common disease with high incidence in China, but according to experts, there are too few drugs that can cure cor pulmonale at present. Feixin decoction is not as simple as western medicine or traditional Chinese medicine, so it produces drug-resistant strains and makes asthma a chronic disease.

On the one hand, it inhibits bacterial metabolism, on the other hand, it improves cellular immunity and humoral immunity. Through the lymphatic factor of immunoglobulin, it devours bacteria, activates complement, neutralizes toxins, fights infection, absorbs inflammation and destroys bacterial viruses. According to clinical statistics, follow-up survey and patient information feedback, the cure rate is as high as 99.6%, and there is no recurrence within three years after drug withdrawal.

2. Knowledge about cor pulmonale

The most common chronic pulmonary heart disease is chronic hypoxic-bloody pulmonary heart disease, also known as obstructive emphysematous heart disease, referred to as cor pulmonale, which refers to a kind of heart disease with or without right heart failure caused by the increase of pulmonary circulation resistance caused by chronic pathological changes of lung thorax or pulmonary artery.

Pulmonary heart disease is a common and frequently-occurring disease in China. The course of the disease progresses slowly, which can be divided into two stages: compensatory stage and decompensated stage, but the boundary is sometimes unclear.

(a) patients with functional compensation have a history of chronic cough, expectoration or asthma, and gradually appear fatigue and dyspnea. Physical examination showed obvious manifestations of emphysema, including excessive unvoiced sounds in bucket chest and lungs, lower upper limit of liver voiced sound, and narrower or even disappeared boundary of heart voiced sound.

Auscultation breath sound is low, there may be dry and wet rales, and the heart sound is light, sometimes it can only be heard under xiphoid process. Hyperactivity of second tone in pulmonary artery area and heartbeat under xiphoid process in upper abdomen are the main manifestations of heart involvement.

The jugular vein may dilate slightly, but the venous pressure will not increase significantly. (2) Severe injury of lung tissue in decompensated period leads to hypoxia and carbon dioxide retention, which may lead to respiratory and/or heart failure.

1. In the early stage of respiratory failure and hypoxia, the main manifestations are cyanosis, palpitation and chest tightness. When the lesion develops further, hypoxemia and hypercapnia may occur, and various mental and neurological symptoms may occur, which is called pulmonary encephalopathy. It is characterized by headache, head swelling, irritability, language disorder, hallucinations, insanity, convulsions or tremors.

When the arterial oxygen partial pressure is lower than 3.3 kPa (25 mm Hg) and the arterial carbon dioxide partial pressure is higher than 9.3 kPa (70 mm Hg), the symptoms of the central nervous system are more obvious, leading to apathy, lethargy, coma and even death. 2. Heart failure often occurs after acute respiratory infection, so it is often complicated with respiratory failure. The patient developed symptoms of right heart failure, such as asthma, palpitation, oliguria, cyanosis, epigastric pain, loss of appetite, nausea and even vomiting.

On physical examination, the jugular vein is dilated, the heart rate is increased, and the systolic murmur caused by galloping rhythm or tricuspid valve relative insufficiency can be heard in the precordial area, which can disappear with the improvement of the condition. All kinds of arrhythmia may occur, especially atrial arrhythmia, hepatomegaly with tenderness, positive anti-hydraulic sign of liver and neck, edema and ascites, and severe shock may occur.

In addition, because cor pulmonale is a multi-organ damage disease based on cardiopulmonary diseases, in severe patients, renal insufficiency, disseminated intravascular coagulation and cheek pigmentation may occur due to adrenal cortical dysfunction. The early manifestations of chronic pulmonary heart disease are chronic cough, expectoration and dyspnea to varying degrees, especially after exercise or in cold season.

The early cardiopulmonary function of cor pulmonale is in the replacement stage, and the patients have no specific symptoms. Patients can be quiet without symptoms, so this disease is not easy to attract people's attention. However, as long as the following situations occur, it is often suggested that you have cor pulmonale: ① Repeated coughing and expectoration for a long time.

② Every cold season, the illness gets worse, the cough gets worse, and the amount of sputum increases, thickens or turns yellow. ③ Symptoms such as shortness of breath, shortness of breath, palpitation, precordial pain, fatigue, chest tightness, etc. may be improved after rest.

④ Fingertips, lips and lips are bluish purple. ⑤ Increased heart rate and arrhythmia.

(1) Bronchopulmonary diseases are divided into two categories: ① Obstructive diseases, such as chronic bronchitis, bronchial asthma and bronchiectasis, are now called chronic obstructive pulmonary disease (COPD). ② Restrictive diseases, such as diffuse pulmonary interstitial fibrosis, tuberculosis, pneumoconiosis, exposure to toxic gases (such as chlorine, carbon dioxide, nitrous oxide, etc.). ), chest radiotherapy, etc. Such as extensive pulmonary fibrosis, sarcoidosis, scleroderma, disseminated lupus erythematosus, dermatomyositis and idiopathic pulmonary hemosiderosis.

(2) Diseases that affect respiratory activities, such as hunchback and other chest deformities after chest plastic surgery, pleural fibrosis, neuromuscular diseases (such as poliomyelitis and muscular dystrophy), obesity with alveolar ventilation disorder, etc. Blood vessels in the lungs may be bent or twisted.

Another cause of cor pulmonale is the long-term contraction of pulmonary vessels caused by hypoxia in chronic altitude sickness. The main pathological changes of chronic hypoxic-bloody pulmonary heart disease are as follows: (1) Bronchial lesions: bronchial mucositis, thickening, mucous gland hyperplasia, hypersecretion, acinar dilatation with a large number of secretions, inflammatory exudates and mucus secretions staying in the bronchial cavity, forming inflammatory plugs or mucus plugs, and the bronchial ciliary epithelium is damaged to varying degrees, which involves the purification function of ciliary epithelium.

The lesion spreads downward to bronchioles, and smooth muscle hypertrophy can occur, making the lumen narrow and irregular; In addition, changes such as wall spasm, cartilage destruction and easy closure of lumen when breathing gas will make bronchioles incomplete or completely blocked. (2) Alveolar lesions Due to the above lesions in the bronchi, the residual gas in the alveoli blocked by the exhaust pipe increases, the pressure increases, and the alveoli expand excessively, so that the bubble wall passively expands on the basis of the damage of elastic fibers, and the bubble wall ruptures, so that several small bubbles merge into one big bubble, forming emphysema.

(III) Pulmonary vascular disease Chronic obstructive pulmonary disease often recurs with inflammation and pneumonia around bronchi, which spreads to bronchial arteries and nearby pulmonary artery branches, making bronchial arteries thicken to varying degrees, leading to muscular pulmonary arterioles, media muscle hypertrophy, increased area of type I and II collagen and fibrous thickening of intima of pulmonary arterioles. In addition, there may be nonspecific pulmonary vasculitis and pulmonary intravascular thrombosis.

About 30% patients have dilated communicating branches, which can produce arteriovenous shunt. (4) Hypertrophy of right ventricle, thickening of ventricular wall, dilatation of cardiac cavity, dilatation of pulmonary artery cone, hypertrophy and atrophy of myocardial fibers, interstitial edema and focal necrosis, which were replaced by fibrous tissue.

Some patients may be complicated with coronary atherosclerosis. This disease develops from a chronic and extensive lung-chest disease, and the symptoms of respiratory and circulatory system often mix, so it is difficult to diagnose heart disease at an early stage.

It is generally believed that patients with chronic extensive lung and chest diseases can be diagnosed as pulmonary hypertension and right ventricular enlargement once other heart diseases causing right ventricular enlargement are found and excluded. (1) Blood tests showed that the red blood cell count and hemoglobin often increased.

3. Introduction of some common sense about cor pulmonale

Hello, cor pulmonale is the abbreviation of pulmonary heart disease, which is pulmonary hypertension secondary to various chest, lung and bronchial diseases, and eventually leads to heart disease characterized by right ventricular hypertrophy.

Most cor pulmonale develops from chronic bronchitis and obstructive emphysema, and a few are related to bronchial asthma, tuberculosis and bronchiectasis. Pulmonary heart disease exists all the year round, more than respiratory failure and heart failure caused by respiratory tract infection in winter and spring, and the mortality rate is high.

This disease belongs to the categories of asthma syndrome, phlegm syndrome, edema and drinking syndrome in traditional Chinese medicine. And cor pulmonale is a common disease with high incidence in China, but according to experts, there are too few drugs that can cure cor pulmonale at present. Feixin decoction is not as simple as western medicine or traditional Chinese medicine, so it produces drug-resistant strains and makes asthma a chronic disease.

On the one hand, it inhibits bacterial metabolism, on the other hand, it improves cellular immunity and humoral immunity. Through the lymphatic factor of immunoglobulin, it devours bacteria, activates complement, neutralizes toxins, fights infection, absorbs inflammation and destroys bacterial viruses. According to clinical statistics, follow-up survey and patient information feedback, the cure rate is as high as 99.6%, and there is no recurrence within three years after drug withdrawal.

4. Symptoms and preventive measures of cor pulmonale

Precautions for prognosis and prevention of cor pulmonale There are two kinds of cor pulmonale: chronic cor pulmonale and acute cor pulmonale. 【 Prognosis 】 Pulmonary heart disease often worsens with the damage of lung function. Most of them have poor prognosis, and the mortality rate is about 10%- 15%. However, active treatment can prolong the life span of patients and improve their quality of life.

【 Prevention 】 It is mainly to prevent and treat diseases such as bronchus, lung and pulmonary vessels that can cause this disease. (a) actively take various measures (including publicity, effective smoking cessation, etc ... ) promote smoking cessation.

(two) actively prevent and control the inducing factors of primary diseases, such as respiratory infection, allergens, inhalation of harmful gases, dust operations and other protective work and personal hygiene education. (three) to carry out various forms of mass sports activities and health education, improve people's health knowledge and enhance disease resistance.

Acute cor pulmonale [Prevention] Actively prevent venous thrombosis or thrombophlebitis. Such as oral aspirin enteric-coated tablets 25-50mg, 1 time/day or dipyridamole 25-50mg, 3 times/day.

It has a certain preventive effect. Patients who stay in bed for a long time should often turn over and move their limbs to help venous blood return smoothly.

Patients should get out of bed as early as possible after operation, and the abdominal band or limb bandage should not be too tight or pressed for too long, so as not to interfere with diaphragm movement and venous reflux of lower limbs. 【 Prognosis 】 The location of pulmonary embolism and the original lung function determine the prognosis.

The natural mortality rate of pulmonary embolism is not completely clear. Less than 65,438+00% of embolism died in acute phase, of which 75% died within 60 minutes after symptoms appeared and the remaining 25% died 48 hours later.

Most pulmonary embolism can be eliminated by blood clot fragmentation, shedding and proteolysis. Or the hemodynamics improved after in-situ organized contraction, and it can return to the original level in about 2-8 weeks. Pulmonary embolism rarely leads to chronic lung diseases, and permanent pulmonary hypertension is also rare.

When embolism occurs frequently and repeatedly without sufficient absorption, chronic pulmonary hypertension will occur, which mainly occurs in patients with chronic diseases.

5. What should I pay attention to in preventing cor pulmonale in my life?

As a common and frequently-occurring disease in respiratory department, cor pulmonale is threatening people's health more and more seriously. In order to better understand pulmonary heart disease, here are some tips on preventing pulmonary heart disease. I hope it will help you: etiology and pathogenesis of cor pulmonale (1) Bronchopulmonary diseases are divided into two categories: ① Obstructive diseases, such as chronic bronchitis, bronchial asthma and bronchiectasis, are called chronic obstructive emphysema.

② Restrictive diseases, such as diffuse pulmonary interstitial fibrosis, tuberculosis, pneumoconiosis, exposure to toxic gases (such as chlorine, carbon dioxide, nitrous oxide, etc.). ), chest radiotherapy, etc. Such as extensive pulmonary fibrosis, sarcoidosis, scleroderma, disseminated lupus erythematosus, dermatomyositis and idiopathic pulmonary hemosiderosis. (2) Diseases that affect respiratory activities, such as hunchback and other chest deformities after chest plastic surgery, pleural fibrosis, neuromuscular diseases (such as poliomyelitis and muscular dystrophy), obesity with alveolar ventilation disorder, etc.

Blood vessels in the lungs may be bent or twisted. Another cause of cor pulmonale is the long-term contraction of pulmonary vessels caused by hypoxia in chronic altitude sickness.

Common sense of prevention of cor pulmonale: Most cor pulmonale is the consequence of chronic bronchitis and bronchial asthma complicated with emphysema, so active prevention and treatment of these diseases is the fundamental measure to avoid cor pulmonale. Pay attention to hygiene, enhance physical fitness, improve general resistance, and reduce the occurrence of colds and various respiratory diseases.

Patients with cor pulmonale should be treated in remission stage and acute stage respectively. This disease is easy to recur, which makes it worse and worse. However, most links in the course of cor pulmonale are reversible. If we can actively control infection in time and improve cardiopulmonary function, it will have positive significance for the prognosis of the disease.

In the remission period, comprehensive measures should be taken to prevent and treat it, such as encouraging patients to take respiratory exercise, cold-resistant exercise and advocating smoking cessation. To prevent or reduce and alleviate acute attacks and delay the further development of the disease. In recent years, popularizing family ltot can improve the prognosis.

Chinese medicine treatment, Chinese medicine believes that the main syndrome of this disease is lung qi deficiency, and its main performance is lung dysfunction. The treatment should be strengthening the body resistance, promoting blood circulation and removing blood stasis, and improving pulmonary circulation.

Feixin decoction can quickly activate the whole respiratory system, nourish alveolar cells, fully repair and activate collapsed and necrotic lung cells, and enhance lung ventilation ability. Rebuild the immune function of respiratory system, so as to achieve the goal of radical cure.