文档介绍：Chronic Pulmonary heart disease
It is directly caused by chronic alterations in pulmonary circulation or chronic chest diseases that lead to pulmonary arterial hypertension, right ventricular enlargement, even right heart failure.
A. Bronchial and pulmonary disorders:
chronic plicated with COPD:
80-90%
asthma, bronchiectasis, tuberculosis, silicosis, chronic interstitial lung disease
B. Disorders of chest movement:(rare)abnormality, adhesion, vertebral tuberculosis、rhumatoid spondylitis 。
C. Disorders of nerve and muscle
Poliomyelitis
disorders of motor-nerve center
D. Disorders of pulmonary vessels
Hypersensitve granuloma
embolism of pulmonary artery
E. pulmonary arterial hypertension of
unknown cause
1). main primary disorders of lung
chronic bronchitis and emphysema
2). changes of pulmonary vessels
A. the wall of pulmonary vessels
thickening, narrowing, or obliterative
B. capillary bed of alveolar wall
damaged , decreased
C. vascular bed of lung
compressed to be irregular
3). changes of the heart
increased heart weight
hypertrophy of right ventricle
enlargement of right ventricle
4. Pathophysiology and pathogenesis
A. pulmonary arterial hypertension
1). organic changes of pulmonary vessels
a. thickening of the vessels
b. deterioration of emphysema
c. Decreased capillary bed:>70%
2). functional changes of pulmonary vessels
factors of body fluid, tissue and nerve
3). remodeling of pulmonary vessels
vasoconstriction of vessels
hypertrophy of smooth muscle cell
4). increased blood volume and increased blood
viscosity
hypoxia RBC blood viscosity
resistance of blood flow
Load of right ventricle and hypertrophy of right ventricle
early stage: compensated
acute exacerbation :petency
cardiac output
B. Changes of right heart function
C. Impairment of the other ans
Brain, liver, kidney
digestive canal, et al