Acute cor pulmonale

Acute cor pulmonale is a heart disease mainly caused by sudden embolism of the main pulmonary artery or its major branches, with extensive obstruction of the pulmonary circulation, resulting in a sharp increase in pulmonary artery pressure, acute right ventricular dilation, and right ventricular failure. Since this disease is mainly seen in patients with massive pulmonary embolism, acute cor pulmonale results from emboli originating from the venous system or the right heart becoming dislodged or other foreign bodies entering the pulmonary circulation, causing extensive embolism of the main pulmonary artery or its branches, accompanied by widespread spasm of the small pulmonary arteries, leading to obstruction of the pulmonary circulation and a sharp rise in pulmonary artery pressure, causing right ventricular dilation and right heart failure. There is sudden dyspnea, chest pain, chest tightness, palpitations, and a sensation of suffocation, but the patient can lie flat. There may be violent coughing or coughing of bright red blood-streaked sputum, which becomes dark red after several days. Moderate fever, nausea, and vomiting may occur. In severe cases, there may be syncope, shock, and even death, cyanosis, and increased respiratory rate. Percussion over the large pulmonary infarcted area reveals dullness, breath sounds are diminished or accompanied by dry and moist rales. The heart rate is increased, the pulmonary valve second heart sound is accentuated, and there are systolic and early diastolic murmurs. Arrhythmias, jugular venous distention, hepatomegaly with tenderness, jaundice, and bilateral lower extremity edema may be present.