Cor Pulmonale or Dilated Cardiomyopathy?

Hi I'm Marc,

I have an essay about this casestudy and I really need help...

Well a patient with chronic bronchitis complains of worsened dyspnea at exertion and it worsens at rest.

There are alot of details but from what I've researched the patient could have cor pulmonale as there is right ventricular hypertrophy. But as i further researched I found that most of the clinical manifestations also matched dilated cardiomyopathy.

Other significant cues include;
- Jugular Vein distention
- slight hypotension
- elevated Leukocytes ( monocytes and lymphocytes)
- increased reticulocytes ( I am thinking the patient is anemic)
- tachypnea
-butterfly/ bat's wing pattern in chest xray
- orthopnic

These two complications have such similar manifestations I've gotten confused. I am leaning towards cor pulmonale as there is a history of COPD but dilated cardiomyopathy is usually idiopathic.

Please help.

[kenkeith]

The confusion may be caused by not understanding the less known right side cardiomyopathy.  When a person has cor pulmonade that causes a weakness of the right ventricle of the heart. The weakness is caused by high blood pressure in the vessels that deliver blood from the right ventricle to the lungs and as result there is right-sided cardiomyopathy (enlarged right ventricle). Chronic cor pulmonale results in right-sided congestive heart failure. Common causes of cor pulmonale include bronchiectasis, COPD, cystic fibrosis, pneumoconiosis, and primary pulmonary hypertension (conditions are respiratory defects).

Hope this helps, and if you have any followup questions you are welcome to respond.  Take care.