Pulmonary heart Disease

 

Pulmonary Heart Disease 

Definition

It is a condition ,characterized by disturbance in the pulmonary circulation  due to a  disease of the lungs.

Classification

1.Acute Pulmonary embolism.

2.Chronic or pulmonale.

 

Pulmonary Embolism

Definition

It is a  condition resulting from obstruction of pulmonary artery.

 

Classification

 

1.Massive Pulmonary embolism :It is due to a major obstruction in the main pulmonary artery. Such a patient may die suddenly.

2.pulmonary infraction : This is observed in cases of heart disease. It characterized by fever , tachycardia, pain in the chest, and hemoptysis. It is due to obstruction in the blood supply to the lung, so that the ischemic tissue dies.

3.Recurrent pulmonary thromboembolism: It is due to repeated showers of small emboli in the pulmonary circulation.

 

Aetiology

 

1.Cardiac failure.

2.Old age.

3.Bed ridden state for prolonged period.

            -Serious illness.

             -Postoperative period.

4. Puerperium: Period of 6 weeks after delivery.

5.Pills containing oestrogen, e.g. combination contraceptive pills.

6.Atrial fibrillation : It causes thrombus formation in the heart.

 

Clinical Features 

1.Shock : Blood supply to the heart and brain is stopped due to obstruction to the pulmonary circulation.

2.Dyspnoea.

3.Tachypnoea.

4.Chest pain :stabbing in nature.

5.Hemoptysis:passage of blood in the sputum.

6.Elevation of jugular venous pressure.

7.Irregularity of the heart rate.

8.Hypotension.

9.Oliguria.

10.Cold, clammy skin.

11.Cyanosis.

12.Features of pleural effusion after 24 to 48 hours.

13.Low grade fever.

 

Investigations

1.ECG

2.Chest X-ray

3.Pulmonary angiography

4.Lung scan

 

 

Treatment

1.Complete bed rest is given . Head low position is given to prevent or treat shock.

2.Airway is cleared if it contains any secretions.

3.Oxygen is given to relieve hypoxia.

4.Morphine or Pethidine is given to relieve pain and decrease anxiety.

5.Anticoagulation is started simultaneously and continued for 3weeks.

6.Coagulation studies are continued while the anticoagulation are being given.

7.Antibiotics are given to prevent superadded infection.

8.Drugs like mephitine are given for hypotension.

9.Streptokinase is given to dissolve the intravascular clot.

10.Nursing care is given as for myocardial infraction.