Answer to the last #DiagnosticDilemma
Final Dx: A. Cor pulmonale

This patient has signs and symptoms of right heart failure, including progressive dyspnea, hepatojugular reflux, pulsus paradoxus, and ventricular gallop, and a history of chronic obstructive pulmonary disease; thus, he likely has cor pulmonale.

Chronic obstructive pulmonary disease is the most common cause of cor pulmonale, with approximately 30% of patients with chronic obstructive pulmonary disease going on to develop cor pulmonale.

In general, the use of diuretics in patients with cor pulmonale should be handled with caution because they can be sensitive to a decrease in cardiac output, which can precipitate acute renal failure.

Major Takeaway:-
Signs and symptoms of right heart failure in the context of a pulmonary disease, such as chronic obstructive pulmonary disease, is also known as cor pulmonale.

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Dr. Z●●s D●●●●●a
Dr. Z●●s D●●●●●a Internal Medicine
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Sep 21, 2018Like1