Background and Aim: Chronic obstructive pulmonary disease may result in chronic cor pulmonale, which is defined as right ventricular dilatation and/or hypertrophy resulting from pulmonary hypertension. A non-spesific clinical presentation and limited access to advanced diagnostic tools in resource-constrained settings make early diagnosis challenging. To evaluate the clinical profile and diagnostic findings from chest radiography, electrocardiography (ECG), and two-dimensional echocardiography in patients with clinically confirmed chronic cor pulmonale. Materials and Methods: A retrospective observational study was conducted at a tertiary care center from October 2016 to September 2018. A total of 50 patients aged 30 to 80 years with clinically diagnosed chronic cor pulmonale were enrolled. Clinical symptoms, radiographic changes, ECG findings, pulmonary function tests (PFTs), and echocardiographic parameters were studied. Results: The mean age of patients in our study was 51.7 years, with a male predominance (92%). The most common presenting features included breathlessness (100%), productive cough (100%), swelling of the feet (86%), and loss of appetite (92%). Chronic bronchitis with emphysema was the most frequent etiology, accounting for 58% of cases. Chest X-rays revealed chronic bronchitis with emphysema in 58% of patients, increased transverse cardiac diameter in 40% of patients, and a right descending pulmonary artery diameter greater than 16 mm in 62% of patients. ECG findings included right axis deviation (86%), P pulmonale (74%), low-voltage QRS complexes (52%), and arrhythmias (72%). Obstructive patterns were observed in 96% of PFTs. Echocardiography demonstrated dilation of the right ventricle and right atrium in all patients, right ventricular hypertrophy in 84% of patients, pulmonary hypertension in 90% of patients, and tricuspid regurgitation in 90% of patients. Moderate-to-severe pulmonary hypertension was observed in 74% of patients. Conclusion: In the present study, chronic bronchitis with emphysema was the predominant cause of chronic cor pulmonale among middle-aged males. Multimodal assessment using clinical, radiographic, ECG, and echocardiographic findings enables early diagnosis. Echocardiography serves as a critical tool for evaluating right heart involvement and guiding timely intervention in chronic cor pulmonale.
Haq et al. (Fri,) studied this question.
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