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The pathophysiology of pulmonary heart disease (cor pulmonale) has always indicated that an increase in right ventricular afterload causes RV failure (pulmonary vasoconstriction, anatomic disruption/pulmonary vascular bed and increased blood viscosity are usually involved [1]), however most of the time, the right ventricle adjusts to an overload in chronic pressure.
On physical examination, characteristic findings are the presence of a raised jugular venous pressure, a palpable parasternal heave, a heart murmur due to blood leaking through the tricuspid valve, hepatomegaly (an enlarged liver), ascites and leg edema. [7] Cor pulmonale occurs in about a third of all people with OHS. [5]
Generally, diseases outlined within the ICD-10 codes I26-I28 within Chapter IX: Diseases of the circulatory system should be included in this category. Pages in category "Pulmonary heart disease and diseases of pulmonary circulation"
Patients with CHS also have a sensitivity to sedatives and narcotics, which makes respiration even more difficult. A low concentration of oxygen in the red blood cells also may cause hypoxia-induced pulmonary vasoconstriction and pulmonary hypertension, culminating in cor pulmonale or a failure of the right side of the heart. [8]
The murmur is heard due to a high velocity flow back across the pulmonary valve; this is usually a consequence of pulmonary hypertension secondary to mitral valve stenosis. The Graham Steell murmur is often heard in patients with chronic cor pulmonale (pulmonary heart disease) as a result of chronic obstructive pulmonary disease. [citation needed]
Treatment of heart failure, like most secondary disorders, depends upon treatment of the primary cause which includes CAD & MI but also valvular problems like aortic stenosis and hypertension. Cor pulmonale – Untreated cor pulmonale can cause right heart failure from chronic pulmonary hypertrophy.
Dementia may occur when neurodegenerative and cerebrovascular pathologies are mixed, as in susceptible elderly people (75 years and older). [2] [5] Cognitive decline can be traced back to occurrence of successive strokes. [4] ICD-11 lists vascular dementia as dementia due to cerebrovascular disease. [1]
Fat embolism syndrome occurs when fat enters the blood stream (fat embolism) and results in symptoms. [1] Symptoms generally begin within a day. [1] This may include a petechial rash, decreased level of consciousness, and shortness of breath. [1] Other symptoms may include fever and decreased urine output. [2] The risk of death is about 10%. [2]