A patient, age 68, has a long history of COPD and is admitted to the hospital with cor pulmonale. He says his doctor said his heart was failing and asks whether he is having a heart attack. Which explanation by the nurse is most correct?
a. "You aren't having a heart attack, but your heart has been damaged by changes in your lungs caused by your respiratory disease."
b. "It could be a heart attack, and when the heart is damaged it causes respiratory damage, too."
c. "It isn't a heart attack, but your heart has gradually weakened over the years, causing respiratory disease."
d. "It is probably a heart attack, since cor pulmonale means that the heart isn't getting enough blood and becomes too weak to pump effectively."
A
COPD can lead to cor pulmonale, an abnormal cardiac condition characterized by hypertrophy of the right ventricle of the heart as a result of hypertension of the pulmonary circulation. Cor pulmonale results in the presence of edema in the lower extremities as well as in the sacral and perineal area, distended neck veins, and enlargement of the liver with ascites.
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