Professional Documents
Culture Documents
Cor Pulmonale
Lung and
Airways
COPD
Asthma
Bronchiectasis
DILD
Pulmonary
tuberculosis
Vascular
Occlusion
Multiple Emboli
Schistosomiasis
Filariasis
Sickle Cell
P. Pulmonary
Hypertension
Thoracic Cage
Kyphosis > 100 o
Scoliosis > 120 o
Thoracoplasty
Pleural fibrosis
N-M Disease
Polio Myelitis
Myasthenia
Gravis
ALS
Muscular
Dystrophy
Hypercapnea
H
Hypoxia
Acidemia
A
Increased
Viscosity
Acidosis
Anatomic changes
Pulmonary Vessel
Restriction
Increased C.O.
C
Pathologic Features
Natural History
Prevalence
Emphysema : less frequent
Cronic bronchitis : more common
US : 6-7 % of Heart failure
Delhi : 16%
Sheffield in UK : 30 40%
Autopsy in Chronic Bronchitis : 50%
More prevalent in pollution area or
smokers
Lab. Findings
X-Ray : Prominent pulmonary hilum
pulmonary
artery dilatation
Rt MPA > 20 mm
EKG : P- pulmonale, RAD, RVH
Echocardiography : RVH, TR, Pulm. Hypertension
ABG : Hypoxemia, Hypercapnea, Respiratory
acidosis
CBC : polycythemia
Cardiac catheterization
Treatment
Treat Underlying Disease : COPD Tx, Steroid,
Infection control, theophylline, medroxyprogesterone,
Continuous O2 : < 2-3L/min
Diuretics
Phlebotomy
Digoxin : controversial
Pul. Vasodilators
Beta adrenergic agents
Reduce Ventilation/Perfusion imbalance : Amitrine
bimesylate
Prognosis
PENYAKIT JANTUNG
PARU
COR PULMONALE
CHRONIKA
PROF. DR. SAHARMAN LEMAN. DTMH & H. SpPD. KKV
- Patologis.
- Hipertrofi & Dilatasi Ventrikel Kanan
- O.K Hipertensi Pulmonal :
1. Penyakit Parenkim Paru
2. KLN. Vaskuler Paru
3. KLN. Toraks
Definisi
14
PPOM
Ventilasi
Hipoksemia
Asidosis
Polisitemia
Hipervolemia
Curahan Jantung
PATOFISIOLOGI
15
Hipertensi Pulmonal
Ventrikel Kanan >
Kegagalan Ventrikel
Kanan
ETIOLOGI
17
18
1. Gejala Klinis :
- G.J Kanan
- KLN. Paru
2. Pemeriksaan Fisis
-Peny, Paru
- Kesadaran
/ Koma
- JVP
- Hepatomegali, Asites, Edema
- Cor - Ventrikel Kanan >
DIAGNOSIS
19
3. X - Foto Toraks
- Paru
- Jantung
4. EKG
5. Analisa Gas Darah
- Pa O2 , Pa CO2
6. Fungsi Paru
20
Tujuan
- Hipoksemia
- Retensi CO2
- Atasi Obstruksi
Cara
1. Umum
- Polusi Udara
- Fisioterapi
- Postural Drainage
PENATALAKSANAAN
21
2. Fungsi Paru
- Bronkodilator
- Mukolitik, Ekspektoransia
- Anti Biotik
3. Pemberian Oksigen
- O2 < 30%, Intermitent 1 - 3 l/mnt
4. Payah Jantung Kanan
- RG.
- Diuretika
- Digitalis
5. Flebotomi : HT > 80%
22