Cor pulmonale

Published on 02/04/2015 by admin

Filed under Internal Medicine

Last modified 02/04/2015

Print this page

rate 1 star rate 2 star rate 3 star rate 4 star rate 5 star
Your rating: none, Average: 0 (0 votes)

This article have been viewed 904 times

102 Cor pulmonale

Instruction

Examine this patient’s chest.

Salient features

History

• Symptoms of COPD (p. 369)

• Easy fatiguability, shortness of breath on exertion, weakness

• Leg oedema, and right upper quadrant pain.

Examination

• Patient is short of breath at rest and is centrally cyanosed

• Tar staining of the fingers

• JVP is raised: both ‘a’ and ‘v’ waves are seen, ‘v’ waves being prominent if there is associated tricuspid regurgitation

• On examination of the chest, there is bilateral wheeze and other signs of chronic bronchitis (p. 368).

Proceed as follows:

• Examine the cardiovascular system for signs of pulmonary hypertension:

• Left parasternal heave (often absent when the chest is barrel shaped)
• Right ventricular gallop rhythm
• Loud P and a loud ejection click
• Pansystolic murmur of tricuspid regurgitation
• Early diastolic Graham Steell murmur in the pulmonary area.

• Look for signs of:

• Hepatomegaly
Buy Membership for Internal Medicine Category to continue reading. Learn more here

Related posts:

Default ThumbnailSixth cranial nerve palsy Osteoarthrosis Optic atrophy Default ThumbnailHepatomegaly Carotid artery aneurysm Felty’s syndrome