Prevalence and Incidence of Cor pulmonale
Cor pulmonale Prevalence: Book Excerpts
Prevalence/Incidence of Cor pulmonale: Online Medical Books
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Review excerpts from medical books online, free, without registration,
for more information about the prevalence and/or incidence of Cor pulmonale.
Cor pulmonale:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
Approximately 85% of patients with cor pulmonale have COPD, and 25% of patients with COPD eventually develop cor pulmonale.
Other respiratory disorders that produce cor pulmonale include:
❑ obstructive lung diseases — for example, bronchiectasis and cystic fibrosis
❑ restrictive lung diseases — for example, pneumoconiosis, interstitial pneumonitis, scleroderma, and sarcoidosis
❑ loss of lung tissue after extensive lung surgery
❑ congenital cardiac shunts — such as a ventricular septal defect
❑ pulmonary vascular diseases — for example, recurrent thromboembolism, primary pulmonary hypertension, schistosomiasis, and pulmonary vasculitis
❑ respiratory insufficiency without pulmonary disease — for example, in chest wall disorders such as kyphoscoliosis, neuromuscular incompetence due to muscular dystrophy and amyotrophic lateral sclerosis, polymyositis, and spinal cord lesions above C6
❑ obesity hypoventilation syndrome (pickwickian syndrome) and upper airway obstruction
❑ living at high altitudes (chronic mountain sickness).
Pulmonary capillary destruction and pulmonary vasoconstriction (usually secondary to hypoxia) reduce the area of the pulmonary vascular bed. Thus, pulmonary vascular resistance is increased, causing pulmonary hypertension. To compensate for the extra work needed to force blood through the lungs, the right ventricle dilates and hypertrophies. In response to low oxygen content, the bone marrow produces more red blood cells (RBCs), causing erythrocytosis. When the hematocrit (HCT) exceeds 55%, blood viscosity increases, which further aggravates pulmonary hypertension and increases the hemodynamic load on the right ventricle. Right-sided heart failure is the result.
Cor pulmonale accounts for about 25% of all types of heart failure. It’s most common in areas of the world where the incidence of cigarette smoking and COPD is high; cor pulmonale affects middle-age to elderly men more often than women, but incidence in women is increasing. In children, cor pulmonale may be a complication of cystic fibrosis, hemosiderosis, upper airway obstruction, scleroderma, extensive bronchiectasis, neurologic diseases affecting respiratory muscles, or abnormalities of the respiratory control center.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Pulmonary hypertension:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
Pulmonary hypertension begins as hypertrophy of the small pulmonary arteries. The medial and intimal muscle layers of these vessels thicken, decreasing distensibility and increasing resistance. This disorder then progresses to vascular sclerosis and obliteration of small vessels.
In most cases, pulmonary hypertension occurs secondary to an underlying disease process, including:
❑ alveolar hypoventilation from chronic obstructive pulmonary disease (most common cause in the United States), sarcoidosis, diffuse interstitial disease, pulmonary metastasis, and certain diseases such as scleroderma (In these disorders, pulmonary vascular resistance occurs secondary to hypoxemia and destruction of the alveolocapillary bed. Other disorders that cause alveolar hypoventilation without lung tissue damage include obesity, kyphoscoliosis, and obstructive sleep apnea.)
❑ vascular obstruction from pulmonary embolism, vasculitis, and disorders that cause obstruction of small or large pulmonary veins, such as left atrial myxoma, idiopathic veno-occlusive disease, fibrosing mediastinitis, and mediastinal neoplasm
❑ primary cardiac disease, which may be congenital or acquired. Congenital defects that cause left-to-right shunting of blood — such as patent ductus arteriosus or atrial or ventricular septal defect — increase blood flow into the lungs and, consequently, raise pulmonary vascular pressure. Acquired cardiac diseases, such as rheumatic valvular disease and mitral stenosis, increase pulmonary venous pressure by restricting blood flow returning to the heart.
Primary (or idiopathic) pulmonary hypertension is rare, occurring most commonly — and with no known cause — in women between ages 20 and 40. Secondary pulmonary hypertension results from existing cardiac, pulmonary, thromboembolic, or collagen vascular diseases or from the use of certain drugs.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Cor Pulmonale:
Cor Pulmonale - epidemiology
(The 5-Minute Pediatric Consult)
- Cor pulmonale may be found at any age, but is typically due to a long-standing pulmonary process. However, severe BPD is an increasingly common cause of neonatal PH.
- Primary pulmonary hypertension (PPHN) is most often diagnosed in the 2nd or 3rd decade of life with a female predominance, and it is often diagnosed during pregnancy.
Cor Pulmonale - incidence
- PPHN has a yearly incidence of 2/106.
- The incidence of cor pulmonale is dependent on the severity of the underlying lung pathology.
Cor Pulmonale - prevalence
- Upwards of 2/1000 NICU patients will develop significant cor pulmonale.
- 2% of infants undergoing cardiac surgery will have PH with an associated mortality of 10–20%.
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Source: The 5-Minute Pediatric Consult, 2008
Pulmonary Hypertension:
Pulmonary Hypertension - epidemiology
(The 5-Minute Pediatric Consult)
Pulmonary Hypertension - incidence
Incidence in children is unknown.
» READ BOOK EXCERPT ONLINE »
Source: The 5-Minute Pediatric Consult, 2008
About prevalence and incidence statistics:
The term 'prevalence' of Cor pulmonale usually refers to the estimated population
of people who are managing Cor pulmonale at any given time.
The term 'incidence' of Cor pulmonale refers to the annual diagnosis rate,
or the number of new cases of Cor pulmonale diagnosed each year.
Hence, these two statistics types can differ:
a short-lived disease like flu can have high annual incidence but low prevalence,
but a life-long disease like diabetes has a low annual incidence but high prevalence.
For more information see about prevalence and incidence statistics.
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