DRG Category: 315
Mean LOS: 4.5 days
Description MEDICAL: Other Circulatory System Diagnoses with CC
Cor pulmonale is right-sided hypertrophy of the heart caused by pulmonary hypertension. Cor pulmonale is estimated to cause approximately 5% to 7% of all types of heart disease in adults, and chronic obstructive pulmonary disease (COPD) due to chronic bronchitis or emphysema is the causative factor in more than 50% of people with cor pulmonale. It causes increases in pulmonary resistance, and as the right side of the heart works harder, the right ventricle hypertrophies. An increase in pulmonary vascular resistance is the result of anatomic reduction of the pulmonary vascular bed, pulmonary vasoconstriction, or abnormalities of ventilatory mechanics.
A number of physiological changes lead to poor gas exchange. Alveolar wall damage results in anatomic reduction of the pulmonary vascular bed as the number of pulmonary capillaries are reduced and the vasculature stiffens from pulmonary fibrosis. Constriction of the pulmonary vessels and hypertrophy of vessel tissue are caused by alveolar hypoxia and hypercapnia. Abnormalities of the ventilatory mechanics bring about compression of pulmonary capillaries. Cor pulmonale accounts for approximately 25% of all types of heart failure. Complications of cor pulmonale include biventricular heart failure, hepatomegaly, pleural effusion, and thromboembolism related to polycythemia.