Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
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