Managing pulmonary hypertension and cor pulmonale: Chronic obstructive pulmonary disease in over 16s: diagnosis and management

Excerpt

The aim of this review question was to determine the effectiveness of different approaches to managing pulmonary hypertension and cor pulmonale secondary to COPD.

Pulmonary hypertension (PH) is a common complication of COPD that is associated with a worse disease prognosis, including an increased risk of exacerbations, reduced exercise capacity and reduced survival. PH is defined as raised pressure in the arteries on the right side of the heart that take blood to the lungs. PH can occur alone or as a result of other diseases that affect the heart or lungs such as COPD. Pulmonary artery hypertension is defined in this guideline as a mean pulmonary artery pressure of 25mm Hg or more. Pulmonary hypertension is usually a marker of more severe lung disease and over time this can develop into cor pulmonale.

Cor pulmonale is impairment in the structure and function of the right side of the heart caused by a chronic lung disease with renal fluid retention due to hypoxia/hypercapnia. This typically presents with swollen ankles and lower legs.

This review identified studies that fulfilled the conditions specified in Table 1. For full details of the review protocol, see appendix A.