Diagnostic criteria for cor pulmonale, these identification bases

The most common diagnostic criterion for cor pulmonale is the patient's medical history. Generally, patients will have emphysema, chronic bronchitis, chronic cough, and similar symptoms. They can go for relevant tests, such as blood tests, which can help diagnose the condition.

1. Diagnosis and Differentiation of Cor Pulmonale

1. Chronic bronchitis, emphysema and other diseases that cause structural or functional damage to the lungs, leading to pulmonary hypertension and right heart hypertrophy.

2. There are symptoms of chronic cough, sputum production and signs of emphysema, enhanced systolic beats under the xiphoid process and/or significantly enhanced heart sounds or systolic murmurs in the tricuspid valve area, and significantly hyperactive second heart sound in the pulmonary valve area (compensatory stage of cardiopulmonary function). Symptoms such as palpitations, shortness of breath, cyanosis and right heart failure (cardiopulmonary decompensation stage) may occur after acute respiratory infection or strenuous activity.

3. Chest X-ray diagnosis

(1) Dilatation of the right lower pulmonary artery trunk: transverse diameter >= 1.5 cm. After dynamic observation, the transverse diameter of the arterial trunk widened by more than 2mm.

(2) The pulmonary artery segment is bulging, with a height of >= 3 mm.

(3) The dilation of the central pulmonary artery and the slenderness of the peripheral branches form a sharp contrast, appearing like a "stump".

(4) The protruding height of the cone in the right anterior oblique position is greater than or equal to 7 mm.

(5) Enlargement of the right ventricle (judged based on different body positions). Patients with two or more of (1) to (4) or one of (5) can be diagnosed.

2. Auxiliary examination

1. Blood test

The red blood cell count and hemoglobin are often increased, the hematocrit is normal or high, the whole blood viscosity, plasma viscosity and platelet aggregation rate are often increased, the red blood cell electrophoresis time is prolonged, and the erythrocyte sedimentation rate is generally fast; the arterial oxygen saturation is often lower than normal, and the carbon dioxide partial pressure is higher than normal, which is more obvious in respiratory failure. During the heart failure stage, there may be symptoms of impaired liver and kidney function, such as increased levels of alanine aminotransferase, plasma urea nitrogen, creatinine, blood and urine β2-microglobulin (β2-M), plasma renin activity (PRA), and plasma angiotensin II. When combined with respiratory tract infection, the white blood cell count may increase. Changes such as high potassium, low sodium, low potassium or low chloride, low calcium, and low magnesium may occur in different stages of respiratory failure.

(ii) Sputum bacterial culture

The most common bacteria are group A Streptococcus, influenza bacillus, pneumococcus, Staphylococcus, Neisseria, and viridans streptococci. In recent years, the number of Gram-negative bacteria has increased, such as Pseudomonas aeruginosa and Escherichia coli.